


Doctors of S.H.I.E.L.D.

by kitlee625, Sarahastro



Series: Doctors AU [1]
Category: Agents of S.H.I.E.L.D. (TV), The Avengers (Marvel Movies)
Genre: Alternate Universe, Gen
Language: English
Status: In-Progress
Published: 2013-12-06
Updated: 2014-02-09
Packaged: 2018-01-03 15:07:08
Rating: General Audiences
Warnings: No Archive Warnings Apply
Chapters: 14
Words: 44,865
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/1071891
Author URL: https://archiveofourown.org/users/kitlee625/pseuds/kitlee625, https://archiveofourown.org/users/Sarahastro/pseuds/Sarahastro
Summary: <blockquote class="userstuff">
              <p>AU. A year after a near-fatal heart attack, Dr. Coulson returns to S.H.I.E.L.D. Memorial Hospital determined to turn its mediocre residency program into one of the best.</p>
            </blockquote>





	1. What You Do With It

**Summary for the Chapter:**

> Based on Season 1, Episode 1, “Pilot”

Dr. Phil Coulson stared at the stack of applications on his desk and wondered what he had been thinking. At the time it had seemed like a great opportunity to rebuild his career and give something back to the hospital that had literally saved his life. However now he could not help but wonder if everyone was right, that the residency program at S.H.I.E.L.D. Memorial Hospital was a lost cause. S.H.I.E.L.D. was far more famous as a biomedical research facility; its small teaching hospital was essentially an afterthought. It had never attracted the cream of the crop in terms of residents, and most of the faculty had trained elsewhere.

However one year ago those mediocre residents had been the ones to save his life after he collapsed in his office with a massive heart attack. He had spent weeks heavily sedated in the Intensive Care Unit under their care. When he finally awoke, he found his friend and mentor, Nick Fury, standing over him.

“Looks like you’re going to make it,” Dr. Fury had said gruffly.

“What happened?” Coulson had asked.

“You had a heart attack. You were in cardiogenic shock. We had to give you a transplant.”

Coulson had reached towards his chest. It was covered with electrodes and wires hooked up to the cardiac monitors. Beneath them he could see a huge bandage running from his clavicle to just below his rib cage.

“A transplant?”

Fury nodded. “It was the only way to save you.”

Coulson wondered who had given consent for the procedure. He had no family, no medical decision maker. The closest thing he had to family were his co-workers at S.H.I.E.L.D. “Thanks.”

“Just get better,” Fury had told him before leaving.

It had taken months before he was strong enough to return to work. Fury had held his position as Professor of Medicine, but he had not been able to reserve his position as Chief of Cardiology. It was not really a surprise. Years ago, he had been an ambitious researcher with a number of successful studies on preventing heart attacks. But after he was promoted, his research had ground to a halt as he found himself overwhelmed by administrative duties. It did not help that part of his job was to corral the unruly cardiology faculty, particularly Tony Stark, the hot-headed genius who had been gunning for his job since the day he arrived from the Cleveland Clinic. Coulson always knew that it was only a matter of time before Stark took his job, and his leave of absence had given him the perfect opportunity.

At first Coulson had tried to take advantage of his lighter administrative responsibilities to jump start his research career. However he no longer found the same satisfaction analyzing data. After living through a heart attack and transplant, just doing research made him feel too detached from the reality of disease. He started working more on the wards but quickly found himself frustrated by the lack of motivation in the residents. Most of them were single-minded future research scientists who cared more about their research projects than they did their patients.

Then one day he got an email announcing that the current residency director was stepping down. Even though he had never considered being residency director before his heart attack, he submitted an application. During the interview Fury had looked at him like he was crazy, but in the end Fury had to give him the job. He was by far the most qualified candidate.

“I hope you know what you’re getting yourself into,” Fury had said when he told him the news.

It turned out that what he was getting himself into is one big headache. The first thing he had to do was pick an incoming intern class. Even though S.H.I.E.L.D. was only a mediocre program, he still had a mountain of applications to go through in order to choose the candidates that they would invite for an interview.

“What do you think about this one - Leo Fitz?” he asked Maria Hill, who had volunteered to help him.

Maria Hill glanced at the application for only a second before shaking her head. “He has an M.D. Ph.D. from Harvard and scored in the 95th percentile on his board exams. There is no way someone like that is going to come here.”

“He wants to be an oncology researcher. That’s how we’ll recruit him. We get candidates like this all the time for fellowship. We’ll convince him that coming for residency will give him a leg up.”

“What about his partner? It says here that he’s couples matching with Jemma Simmons.”

Coulson dug through the stack of applications until he pulled out hers. “Perfect. Also an M.D. Ph.D. from Harvard, also 95th percentile on her boards, and also wants to be an oncology researcher. A matched set.”

Hill snatched her application out of his hands as if not believing that such qualified applicants had applied to S.H.I.E.L.D. She skimmed their files until she found what she was looking for. “Their clinical grades were terrible, and there’s a note in the evaluation from their psych rotation that their professor thought they were pathologically co-dependent. Oh, and they’re not married. Just best friends. Who does the couples match with a friend?” She placed their files in the rejection pile.

Coulson shook his head and moved them to the interview pile. “There’s no rule against that. I want to meet them.”

*****

“Melinda?”

Dr. Melinda May looked up from her computer to see Coulson standing in the doorway of her office.

“No.”

“So you do read your emails. I was starting to wonder.”

“I’m not going back onto the wards.”

“I’m not asking you to. All I need is an associate program director to help me with the administrative work. Select the incoming interns, arrange the schedules, coordinate faculty to cover the wards.”

“I thought Maria Hill was helping you.”

“She helped me go through applications, but she can’t do it full-time because of her other responsibilities. Besides, I want you.”

“You don’t want me. I’m a researcher.”

“I do. Melinda, remember when we were residents together?”

She smiled a little in spite of herself.

“The residents here deserve the kind of experience that we had. They saved my life. I want to reform the program here from the ground up, make it more like what we had.”

“If you feel this much gratitude to the medicine residents, what are you going to do for the surgical residents who actually did your transplant?”

“I’m grateful to the surgeons too, but I’m not in a position to help them like this. Besides, it’s more than that.” He was not sure how to put his feelings into words that would convince May to join him. “This is my second chance at life. I need to do something with it.”

May looked doubtfully at him. “Just because we were chief residents together doesn’t mean that we can run a residency program. That was a long time ago.”

He pulled out his trump card. “If you become the associate program director the department will pay part of your salary. I heard you recently lost some of your funding. This would make up for that.”

She stared at him angrily. For a moment he wondered if he had miscalculated in using this information against her. At last though she said. “I can’t say no." 

He smiled. That was good enough for now.

*****

When Match Day came around Coulson was even more nervous than when he had applied for residency. Unlike back then, residents now were matched into programs by a computer. He waited anxiously for the email that would tell him how many spots he had filled and which applicants had chosen S.H.I.E.L.D.

He was pleasantly surprised to find only a single unfilled spot. That meant that he only had to pick one candidate from the scramble, the grab bag of medical students who had not gotten into a program through the match.

May rolled her eyes when he asked her to help him review the files. They only had a day to fill their spot.

“This is better than I expected. Last year they had to fill a half dozen spots,” he said.

“Some of these people barely graduated medical school.”

Coulson gave her a look. “There are some good candidates here. We only need to find one.”

They read through the applications in silence, sorting them into piles: yes, maybe, and no. The no pile was by far the largest.

“Read this one,” he finally said handing it to May.

May rolled her eyes. “Who would name their child Skye?”

Coulson ignored her comment and let her read the application. She was quiet for a while and then said, “No.”

“She had good board scores, and good evaluations on her internal medicine and surgery rotations.”

“She didn’t apply in internal medicine. She applied in surgery.”

Coulson shrugged. “She applied through the scramble.”

“This is her backup plan. If we accept her, she’ll just leave next year to take a surgery residency.”

“We’ll convince her not to.”

May looked at him like he is crazy. “Her grades and other evaluations aren’t even that good. Why are you arguing for her?”

He just shook his head. “This is my call. She’s in.”

*****

Stark came into his office and shut the door behind him. “What the hell are you doing, Coulson? Why are you wasting your time on this?”

“These residents could be the best. They just need the right opportunities and guidance.”

“These residents are a joke. They’re either rejects who couldn’t find another placement or lab rats who don’t want anything to do with real patients. You used to understand that about this place.”

“They deserve better. They saved my life.”

Stark snorts. “Is that what you think?”

“What do you mean?”

“We weren’t going to let a bunch of residents take care of the chief of cardiology. They’re idiots.”

“Then who -”

“Who do you think? I hadn’t spent that much time in the ICU since residency. And it wasn’t just me. Banner, Barton, Romanov, Rogers, Hill - we took turns taking care of you until the heart transplant came through.”

Coulson fell silent. He was shocked that his colleagues had rallied around him like that. “Maybe that’s the problem,” he said. “We’re not teaching them to be the kind of doctors that we are. We all know how important our residencies were. I want to give them what we had.”

*****

Skye tried not to show how nervous she was on her first day of residency. Orientation the previous day had only been mildly helpful, but at least she had been given her schedule and directions to the office. They were starting something new this year, grouping the interns into small teams that would work together for most of the year. According to her schedule her teammates were Leo Fitz and Jemma Simmons, but Skye had only caught a glimpse of them the day before. 

Their office was tucked into a corner on the sixth floor. It was a cramped room with most of the space taken up by a circular table. Along the far wall there was a long table with three computers crowded together. Two of the computers were occupied. A fourth computer sat behind the door, and Skye almost hit the man sitting at it when she opened the door.

“Sorry.”

He did not even look up. “Careful with the door.”

One wall was taken up entirely by a large whiteboard which was divided into columns headed Intern A, Intern B, Intern C. Beneath each heading there was a list of patients.

“Hi, I’m Skye,” she said to the room in general.

The young man and woman sitting at the bench of computers looked up in unison.

“Hello,” the man said.

“You must be the third intern,” the woman said.

“I’m Leo Fitz. That’s Jemma Simmons.”

They spoke so quickly together that their words flowed as if coming from a single brain. Skye wondered if they knew each other before the program. “Nice to meet you.” She gestured at the man sitting behind the door who had not said another word. “Who’s that?”

“He’s our resident, Grant Ward,” Simmons said.

Ward pointed at the board. “Start looking up your patients. Our attending will be here in fifteen minutes to start rounds.”

Skye wondered how she could already be late on her first day. “Okay. Am I intern A, B, or C?”

“I don’t care,” Ward said.

Simmons said helpfully, “Fitz took the intern A list, and I took intern B. But we can switch if you want.”

“That’s fine.” Skye walked to the board and climbed on a chair to re-write the names. She was glad that Fitz and Simmons had already claimed interns A and B because they each had three patients, while intern C only had one.

As if he could read her mind Ward said, “Don’t get too comfortable with the light workload. You’ll be getting plenty more on call tonight.”

“No one told us me I was on call tonight. I didn’t bring a change of clothes or a toothbrush,” Skye said. 

Ward looked annoyed. “It was in the orientation packet. There are two medicine teams, and we alternate call days. One of the three of you is on call every other day, starting today. I don’t care what schedule you come up with.”

The door opened and in walked Dr. Coulson. Skye had been a little nervous when she had learned that their program director would be her first attending. It had been a long time since she had done any real work. The last half of her senior year of medical school she had gone on an elective to Costa Rica where she and her boyfriend had spent most of their time drinking and exploring the jungle.

“How’s it going?” Coulson said.

“Fine, sir. Ready to round,” Ward said quickly.

Coulson looked surprised. “Already? It’s the first day.”

Ward looked at the interns as if daring them to say otherwise.

“Instead of formal rounds I thought we could see the patients and talk about them as a team. Give the interns some background,” Coulson said.

Ward looked disappointed not to be able to quiz the interns on round, or maybe that was just Skye’s imagination. Fitz and Simmons scrambled to stuff their pockets full of books and papers before they all headed out the door. Most of the team’s patients were on the sixth floor, and they walked down the hall talking about each one. It was remarkably low key, but Skye figured it was because it was the first day. For the most part Ward did the talking while Coulson asked a few questions about each patient. Skye listened and tried to remember everything they were saying. She hoped Ward and Coulson did not think that she was lazy for not writing everything down like Fitz and Simmons.

They were halfway through the patients when Ward’s pager went off.

“We have a new admission,” he said. He glanced at Coulson. “It should only take a few minutes. I can page you when we’re ready to start again.”

Coulson shook his head. “Send one of the interns.”

“The interns?”

“Sure. I want them to take the lead on the patients. I believe Skye is on call tonight.” Ward and Skye both nodded. “We already saw her patient. She can talk to you about this new patient after rounds.”

Ward looked dubious, but all he said was, “I’m forwarding the information to your pager. He’s in the emergency department. That’s on the first floor. As soon as you’re done, page me so we can go over the orders.”

Skye nodded. It took her a few minutes to find her way to the emergency department. She found him in a room with several gurneys separated by curtains hanging from the ceiling.

“Hello. Mr. Peterson?” she said as she pulled aside the curtain.

She was surprised by how young he looked, only in his mid- to late-thirties. He looked thin and tired.

“Hi Mr. Peterson. I’m Skye. I’m going to be your -” She almost said medical student but caught herself. “- your doctor. What brings you into the hospital?”

“I’ve just had this cough forever doctor. It’s not a big deal, but my sister wanted me to get it checked out. My son and I were visiting her today, and I coughed up some blood, and that freaked her out.”

“Where’s your son now?”

“He’s staying with my sister in Prince George’s County. But look, is this really something that I need to come into the hospital for? I don’t have insurance, and I’m between jobs right now, so I can’t afford to be in the hospital while you guys run a bunch of tests.”

“Believe me, I’m not a fan of useless tests either. I promise, we’re not going to admit you unless it’s necessary. Let me do a few things, and I’ll get back to you.”

Skye went over to the emergency department resident. “Are you taking care of Mr. Peters?”

“Yeah. Are you admitting him?”

“Does he really need to be admitted?” Skye asked. “He says he feels fine and has to go home to take care of his son.”

The resident gave her a look like she was stupid. “Go look at his chest x-ray.”

Skye’s face fell as soon as she saw Mr. Peterson’s chest x-ray. He had what looked like a gaping hole in upper part of his right lung. On days when she and Miles had actually gone to work at the clinic in Costa Rica they had seen plenty of patients with the exact same thing.

“I think my patient has tuberculosis,” she told Ward when she got back into the office.

“Why?”

“He has huge cavity on his chest x-ray.”

“That could be a lot of things. You should read about it tonight and talk about it tomorrow on rounds. But if you really think he has tuberculosis, you should make sure he has an isolation room. You don’t want him to spread it around the hospital,” Ward said.

Skye called the nurse to order an isolation room for Mr. Peterson. She meant to go back and explain things to him, but she quickly was overwhelmed with pages. The next few hours passed in a blur of new admissions. She did not realize how much time had passed until she got paged that Mr. Peterson had some questions for her.

When she got to the room he was pacing anxiously. 

“What’s going on?” he asked. “They told me I had to be admitted, and then they moved me to another room.”

Skye felt guilty. “I’m sorry. I was caught up with some other patients. But I took a look at your chest x-ray, and it looks like you have tuberculosis.”

“What?”

“I don’t know that for certain yet. We’ll have to run some more tests.”

“What does that mean?”

“We’ll send some sputum to the lab to look for the infection.”

“So if it’s negative I can go home tomorrow?”

“Well no. We would have to do a procedure where we go into your lungs -”

Mr. Peterson shook his head. “That sounds like something I can’t afford.”

Skye did not know what to say to that. “You need it. This is a serious illness. It can be treated with antibiotics -”

“So give me the antibiotics.”

“I can’t until we know for certain what you have. The antibiotics have side effects, and you have to take them for a year -”

Mr. Peterson stood up and pulled on his coat. “I can’t afford that either. I need to get out of here and pick up my son.”

Skye started panicking. “Wait! You can’t go. This is serious, and we can help you.”

“I know that you’re trying to help me, but I need to go and take care of my son. I have a job interview in a few days. I can come back and get treatment once I have a job and insurance.”

“Please. What if we start with a the sputum test tonight? If that gives us the answer, then we’re done, and we can start treatment.”

Mr. Peterson hesitated, and Skye worried that he was going to say no. But at last he said, “Okay.”

She meant to check on him again later that night, but she was running around like crazy for the rest of the day. By the time she had a moment to rest it was after 1 AM. She went down to the cafeteria and got sandwich and some coffee, then started working on what she was going to present to Coulson on rounds in the morning.

Writing her notes took a lot longer than she expected, especially with the frequent interruptions to fix her medication orders and handle patient concerns. She was almost done with her presentations when she got a page from Mr. Peterson’s nurse. Skye stared at it dumbfounded, wondering if it was a joke. “Peterson left. Please call and give approval to release his bed.”

Skye banged her head on the table.

“What wrong?” 

She turned to see Coulson standing in the doorway of the office. He was carrying a box of Dunkin Donuts and several cups of coffee.

“How was your first call night?”

“My patient left.”

“Was he okay to leave?”

“No. I think he has tuberculosis.” Skye pointed at the computer screen. She had pulled up the chest x-ray in anticipation of rounds so that she could show it off.

“Looks like it.” The words of approval did not make Skye feel as good as she thought they would.

She buried her head in her hands. “What should I do now?”

Fitz and Simmons came in. “What’s going on?” she asked.

“I admitted a patient last night who I think has tuberculosis, but he left this morning before rounds.”

“That’s a reportable disease. Call the public health department, and they’ll take care of it,” Simmons suggested.

“How?” Skye asked.

Fitz shrugged. “I’m not sure. I think they call the police.”

Coulson looked angry. “Absolutely not. No one is calling the police on Skye’s patient. There has to be another way.”

“He didn’t leave a phone number.” She thought back to their initial meeting. “He was staying with his sister in Prince George’s County.”

“Maybe she’s his emergency contact,” Simmons said. She checked in the computer and found a phone number and address.

Skye tried to call the number but got a busy signal. “No one’s there.”

Ward came into the office. “We need to get going. You can try again after rounds.”

After rounds she tried three more times before giving up. 

“I can’t get ahold of anyone,” Skye complained.

Coulson nodded. “Jemma, you said there’s an address.”

“Yes.” She pulled it up in the computer and wrote it on a scrap of paper. “Is there someone we can call, like a social worker?”

Coulson stood up. “That’s not far from here. I’m going to go talk to him.”

“Can I come?” Skye asked.

He gave her an inscrutable look. “Of course.”

They walked to the parking garage in silence, but Skye could not help but snicker when she saw his vintage bright red Corvette.

“Nice car,” she smirked.

“Thanks.”

Having been awake for over 24 hours, Skye fell asleep shortly after they pulled out onto the street and slept the whole way to Mr. Peterson’s sister’s house. When they got the house, Coulson shook her awake.

“I’ll do the talking,” he said.

Skye figured it was a good idea since her last conversation with Mr. Peterson had not gone so well. Plus she was sure that she looked like a mess after her overnight call.

His sister answered the door.

“Hello, Ms. Peterson? I’m Dr. Coulson, from S.H.I.E.L.D. Memorial Hospital,” Coulson said.

“Is this about Mike?” Ms. Peterson asked. “I sent him there yesterday to get checked out, but he came back early this morning. He said everything was fine.”

“Is he still here? We’d like to talk to him.”

“No. He picked up his son and went home. They have an apartment in Takoma Park.”

“Thank you. Do you have the address?”

Skye expected the woman to refuse to give her brother’s address to a stranger, but perhaps she was persuaded by Coulson’s calm authoritative demeanor. “Sure, let me get it for you.”

When they got to the apartment in Takoma Park though no one was home. Coulson went to the apartment office to ask about the Petersons, and the man behind the desk informed them that they had been evicted two weeks ago.

“Where did they go?” Coulson asked.

The man shrugged. “Didn’t say.”

“He lost his job. He was trying to get another one,” Skye remembered. “Now what?”

Coulson glanced at his watch. “The homeless shelters will be opening their doors for the evening. We should check them out.”

They found him at the second homeless shelter they went to. He stared at the Corvette as it pulled into the parking lot.

“That’s him,” Skye said. He had a small boy with him.

“Mr. Peterson? I’m Dr. Coulson from S.H.I.E.L.D. Memorial. Do you have a minute?”

Mr. Peterson panicked. “What are you doing here?”

“We wanted to talk about your recent hospital visit.”

“Look, I’m sorry. I know I shouldn’t have just run off like that without paying my bill, but I couldn’t stay there. I have to take care of my son.”

“We’re not here about the bill. We’re here about your health.”

“I told her, I can’t afford to be sick right now. Once I get back on my feet, get a job, I promise I’ll come back to the hospital.”

“I’m sorry, but this is something that you need to take care of now. It’s very serious and highly contagious.”

Mr. Peterson lowered his voice, “They’ll kick me and my son out of the shelter if they know I have it.”

Skye had not thought of that.

“How long have you been staying at the shelter?” Coulson asked.

Mr. Peterson looked ashamed. “A few weeks. I lost my job a few months ago. I’ve been trying to get some work, but nobody’s hiring. How am I going to find a job if I’m sick?”

“We went by your sister’s house to check on you. She doesn’t know that you were evicted.”

He shook his head. “I don’t want her to know. I can handle this on my own.”

“Mr. Peterson, everyone needs help sometimes. Right now, you’re sick, and we think we can help you. If you do have tuberculosis, we can get you those medications for free from the health department. But you need to get it treated. You may feel fine now, but it is only going to make you weaker, less able to take care of yourself and your son, and you could spread it to other people.”

Mr. Peterson looked down at his feet. “What about my son?”

“I’ll drop him off with your sister while Skye takes you back to the hospital.” He pulled out some money from his wallet.

“How long would I have to stay there?”

“I can’t say for certain, but hopefully just a few days. While you’re there we can help you find a place to stay after you leave the hospital.”

Mr. Peterson nodded slowly. “All right.”

They were silent during most of the cab ride back to the hospital. Skye was just focused on staying awake. She did not think it was very professional to fall asleep in front of your patient. They were almost back when Mr. Peterson said, “Thanks for tracking me down.”

“That’s my job.”

“Not every doctor would do that.”

“Thanks.” She did not know what else to say.

After they got him checked back into the hospital, Skye had to go back up to the office to pick up her stuff. Ward, Fitz, and Simmons were all there. 

“Is everything okay?” Simmons asked.

“Fine. I’m just here to get my stuff, then I’m going home. Oh Fitz, you’re going to get a new patient tonight, my guy Mr. Peterson, but I’ll take him back in the morning.”

“What happened?” Fitz asked.

Skye shook her head. “I’m so tired right now. But I’ll tell you all about it tomorrow.”

“You should take a cab home.” Ward handed her two cab vouchers.

“Thanks.” Skye was touched that he had picked them up for her.

“Get some rest. You look terrible,” Ward said.

Skye nodded. Normally she would be offended if someone said that, but she felt terrible. Her first night on call had been the longest day of her life. It was crazy to think that she would be back at work in just a few hours. “See you guys tomorrow.”


	2. Pieces Solving a Puzzle

**Summary for the Chapter:**

> The residents treat a patient after a heart attack but come into conflict with his former doctor, who also happens to be Coulson’s ex-girlfriend.
> 
> Based on Season 1, Episode 2, “0-8-4”

When Skye arrived in the office, Simmons and Fitz were giddy with excitement.

“We met Dr. Stark yesterday,” Simmons announced.

“What? How?”

“I admitted a patient yesterday who had a heart attack. Dr. Stark did the procedure to open up his blocked artery,” Fitz said.

“Actually it wasn’t a blocked artery. He had a stent that was all clogged up,” Simmons corrected.

“So what was Dr. Stark like?” Skye asked.

Fitz and Simmons exchanged a look. “All he said to me was not to kill the patient after he’d saved his life,” Fitz said.

“But he was rushing to another case. He’s very busy. He’s the chairman of cardiology,” Simmons said.

“He’s a very involved chair,” Fitz said. “Much more so than I heard Coulson was.”

“Coulson used to be chairman of cardiology?” Skye asked.

“Before my heart attack.” The interns turned to see Coulson standing in the office door.

“You had a heart attack? Are you okay? Did they have to put in a stent?” Skye asked.

Coulson shook his head. “They gave me a new heart. Ready for rounds?”

On rounds Coulson looked impressed when he heard Fitz’s presentation on the heart attack patient Mr. Leal. Even Ward did not have much to correct him on.

“Good job, Fitz,” Coulson said. “Why do you think this happened?”

“He must have stopped taking his Plavix,” Fitz said.

“But he said that he took it exactly as prescribed. Never missed a dose,” Coulson reminded him.

Ward jumped in, “Second rule of medicine, Fitz: all patients lie.”

Coulson shook his head. “I know everyone says that, but I want to break us of the habit of assuming that the patient must be lying or at fault. Why else could his stent have gotten clogged?”

Fitz looked confused. “It was just put in a few weeks ago. It shouldn’t have done that if he was taking his Plavix like he was supposed to.”

“But it did. Think about that and get back to me. We have a few more days before he’s healthy enough to go home. Even though Dr. Stark opened up the blockage, the heart attack weakened his heart enough to put him into heart failure. We’ll stabilize him and then discharge him.”

“Give him enough diuretics that we can get him off supplemental oxygen,” Ward told Fitz, “and get the records from his cardiologist. They should say whether he was taking his Plavix or not.”

*****

Ward did not know what to expect when he got an urgent page from Skye to come to Mr. Leal’s room. When he got there, he found the three interns facing down a very angry woman.

As soon as Fitz saw Ward, he said, “Dr. Reyes, is trying to take our patient.”

Reyes glared at the residents. “He is my patient. I want him transferred to my hospital immediately. You don’t want me to tell your attending that you held my patient hostage.”

“What’s going on here?” Coulson asked.

Everyone immediately stopped talking and turned to look at him.

“Phillip?” Reyes asked.

“Camilla?”

She smiled and kissed him on the cheek. The interns and Ward exchanged confused looks.

“I heard that a cardiologist from another hospital was harassing my interns. I didn’t expect it to be you.”

“Your interns have my patient. I want him sent back to Fairfax General.”

Coulson looks at the residents. “How is he?”

“He’s still in heart failure, but the diuretics that we’re giving him are working. His supplemental oxygen is down to 4 liters,” Fitz said.

Coulson looks back at Reyes. “It sounds like he’s not healthy enough to be transferred.”

“He’s stable. He’ll be fine for the ambulance ride.”

“Just because he would probably survive an ambulance ride doesn’t mean we should move him. My team is taking good care of him.”

“I know him better. He’s been under my care for months.”

“Then send over the files so my team can get up to speed.” He smiled. “Sorry you wasted a trip over here. Why don’t I buy you a cup of coffee?”

She gave him an appraising look, and Skye pretended to cough to cover her laugh. “All right. I’ll call my hospital and tell them to send over his chart right away.”

*****

Reyes smirked when Coulson ordered a doughnut along with his coffee. “Should you really be eating that? I heard about your heart attack.”

He sighed. “It’s a lot more fun giving that kind of advice than taking it.”

“They say doctors make the worst patients.” She smiled at him. “You look good.”

“I work out.” They sat down at a small table. “I heard about your promotion to chairman of cardiology. Congratulations.”

“Thank you. What about you? How are you doing?”

“I’m doing well. I just took over as residency director.”

“Residency director?” She looked surprised. “That doesn’t sound like the Phillip I remember. You cared about doing research than training residents.”

He shrugged. “I’ve changed. I want to make this program into one of the best. These residents have great potential. They just need the right teachers.”

“Like who? You?” She is still smiling, but there is something cruel about it now. “You devoted your life to preventing heart attacks and then you almost died from one. You couldn’t even take care of yourself.” He did not say anything. “Or is this about something else? You’ve always been so nostalgic. I remember how much you loved your residency days.”

“I had some good times.”

“Phillip, just admit it. You’re having a midlife crisis. Abandoning your research, starting this new job, surrounding yourself with young, impressionable doctors…”

“Why exactly did you come over here, Camilla?”

“I was checking up on my patient.”

“You could have called. You didn’t have to come over here in person.”

She gave him a flirtatious look. “Maybe I just wanted to see you.” 

“Maybe, but for some reason I doubt that.” He picked up his coffee and doughnut. “Mr. Leal is our patient, and he will be staying here. Now I have to get going. I need to get back to the wards to check in with my residents.”

*****

Fitz was getting ready to go home after his call shift when the fax machine started spitting out papers. “Those must be Mr. Leal’s records,” he said. He went over to the machine to pull them out, but stopped when he realized that the machine was not done. It took several minutes before the records finished printing out, at which point there a stack of pages several inches thick.

“There must be hundreds of pages here,” Fitz complained.

“Don’t worry Fitz, I’ll help you look through them tonight when I get home,” Simmons said.

“Do you guys live together?” Skye asked.

“Yes. We have an apartment not far from here,” Simmons said.

Skye felt a little envious that they were roommates. When she did make it home from the hospital her apartment was always cold and uninviting. She had not even had time to finish unpacking and assembling her IKEA furniture.

“I could help too,” she said. “We could get some food and make a party out of it.” The other medicine team was on call that day, so none of them had to stay overnight.

“Okay,” Simmons said.

“Thanks,” Fitz said gratefully. “I’m going to go home and take a nap until then.”

*****

In contrast to Skye’s unfinished apartment, Fitz-Simmons’ apartment was warm and homey. Fitz ordered Indian food while Simmons made tea, and they sat on the floor of the living room with the records spread out in front of them going through them.

“Most of these are just nursing notes,” Simmons complained.

“Yeah, and every normal lab he’s ever had. How is this supposed to help?” Skye asked.

“Ward and Coulson seem to think it’s going to explain why he his stent got clogged,” Fitz said.

“Okay, so why could that have happened?” Skye asked.

“Well it could be because he has a genetic mutation that makes Plavix not effective. That could show up in his labs.” Simmons started going through the pile of lab results.

“I still think it’s because he stopped taking his Plavix. Ward agrees with me,” Fitz said. “There might be something in the notes about him not being compliant with his medications.” He started going through another pile.

Skye looked at the remaining stack of nursing notes. “Okay. I’ll see if any of this could help us,” she said. She hated to admit that she did not remember how long someone had to be on Plavix for after a stent but finally she asked, “So how long was he supposed to be on it anyway? Plavix is pretty expensive. Maybe he couldn’t afford it.”

“He had a metal stent so he needed 1 month uninterrupted,” Fitz said.

“Well according to these procedure notes the stent was placed six weeks ago, so he was done taking it,” Skye said.

Fitz looked confused. “Maybe it closed up a few weeks ago, but he didn’t get symptoms until yesterday?”

“Or maybe he has a mutation that makes Plavix not effective,” Simmons said.

Skye let them argue about the relative merits of each theory. She was not sure what she should be looking for in the nursing notes, but she did not know what else to do to help. Most of the notes were handwritten instead of typed, and some of the words were hard to read. Then she saw something that made her pause.

“Hey Fitz, I thought you said he had a metal stent.”

“He did. Why?”

“Because this note says it was a drug stent.” She pointed out the relevant line to Fitz and Simmons. It was a handwritten procedure log with columns of vitals and comments along the right hand side. “See, it says 10:42 - Drug stent placed.”

“Maybe it was a mistake and she meant metal stent,” Fitz said, but he did not sound convinced.

“What’s the difference?” Skye asked.

Fitz and Simmons both looked surprised. “Didn’t you learn this in medical school?” Fitz asked.

If she had, she had forgotten it.

Simmons said, “If it’s a drug stent then it will stay open better in the long term, but you have to take Plavix for a whole year. Otherwise it will close up.”

“So if they did put in a drug stent, but they thought it was a metal stent and told him to stop after a month -” Skye said.

Simmons frowned. “That would be a huge mistake.”

*****

As usual Ward was working at the desk behind the office door when Fitz, Simmons, and Skye arrived. Fitz wondered if Ward ever went home. Or if he even had a home. He dropped an armload of records on the table with a loud thump.

“The records came in,” he said. Ward did not even look up from his computer. “There was something weird in them though. It could just be a clerical error, but -”

Ward cut him off. “Get to the point Fitz.”

Fitz handed him the relevant sheets of paper. “In all of his clinic notes it says that he had a metal stent placed six weeks ago, and he was told to stop the Plavix two weeks ago, right on schedule. But this nursing note says that he had a drug stent placed. We can’t tell which one he got.”

Ward pointed to a small sticker on the nursing note. “He got the drug stent. This sticker here is from the packaging for the stent. They put it on the nursing note as a record of which one they used.”

“What do we do now?” Fitz asked.

“How do we tell the patient?” Skye asked.

“Tell the patient what?”

The interns were surprised to see a serious looking Asian woman standing in the doorway. Ward simply nodded.

“Dr. May, the interns discovered something about our patient with the heart attack.”

“Where’s Coulson?” Skye asked.

“He has meetings all day. I’m covering for him.”

“Are you a cardiologist like Coulson?” Simmons asked.

“Oncologist.”

“Do oncologists usually round on the internal medicine wards?” Skye asked bluntly.

She looked coldly at Skye. “I’m board certified in internal medicine as well. What did you find?”

Ward handed her the records that Fitz had given him. “It looks like Dr. Reyes thought she had put in a metal stent when in reality it was a drug stent.”

May studied the records and nodded.

“What we’re wondering now is, what do we do about this information? How do we tell the patient?” Fitz asked.

“We just tell him,” she said. “We will report this to her hospital as well. She shouldn’t have lied about it.”

“Lied?” Simmons asked. Even Ward looked surprised.

May pointed to the bottom of the notes, and the others crowded around her to see. “There’s a time and date stamp here to mark whenever someone made a change to the record. These notes were all changed two days ago.”

“Do they keep a record of what they used to say?” Skye asked.

May nodded. “Have them faxed over immediately.”

*****

When the records came in they showed that their theory was correct. Not only had there been a mix up with the type of stent, but also Dr. Reyes had tried to cover it up when she had learned of her patient’s heart attack. Later that day Coulson came by the office. “What happened with Mr. Leal?” he asked.

“Did Ward tell you about the stent?” Skye asked.

“He did. How did the patient take the news?”

It had been one of the most uncomfortable conversations that Fitz had ever been involved in. Fortunately Ward and May had done most of the talking while he just watched. “Okay I guess,” Fitz said, “but he said that he’s going to sue Dr. Reyes.”

“I’m not surprised,” Coulson said. “How is Mr. Leal doing?”

“Better today. Off oxygen. Dr. May said that he can go home tomorrow,” Fitz said.

“Good. You took good care of him,” Coulson said. 

That seemed to cheer up Fitz and Simmons, but Skye had another question. “What’s going to happen to Dr. Reyes?”

“We reported what happened to her hospital. She’s going to be suspended for a while and may lose her privileges.” He gave the interns a serious look. “Mistakes are part of human nature, but what’s important is what we do next. If anything like this happens to one of you, you can always come to me or another attending. Don’t try to cover it up.”

Skye nodded. “Hey Coulson,” she said, “that reminds me, what happened between you and Dr. Reyes?” He raised his eyebrows. “I mean, you guys totally did it right? Back in the day.”

Simmons and Fitz cringed, but Coulson just looked amused. “That’s confidential.”


	3. A Hard Choice

**Summary for the Chapter:**

> The residents treat a man awaiting a high-risk surgical procedure, but Fitz and Simmons are convinced that he would be better off being treated medically.
> 
> Based on Season 1, Episode 3, “The Asset”

“There aren’t enough attendings to cover the wards,” May said as she and Coulson went over the schedule in his office.

“I thought this might be a problem. You said you were going to recruit more.”

“I’m trying, but I can’t force people to do it. Most of them have their time full with research.”

Coulson rubbed his eyes. He did not want to admit how tired he was from being on the wards every day that month. “Put my name down.”

May looked doubtful as she penciled him in but did not say a word.

*****

“You guys might know one of the patients I admitted last night,” Skye said to Fitz and Simmons. “He’s a professor at Harvard Medicine. Dr. Hall.”

“Oh no, not Dr. Hall,” Simmons said.

“What’s wrong with him?” Fitz asked.

“He was our pathology professor our second year. We just adored him.”

Skye explained, “He’s scheduled for surgery tomorrow, but he was in bad shape, so he’s on the medicine wards until then. He’s having a total colectomy.”

Simmons frowned. “That’s rather drastic. Do you know what’s wrong with him?”

“Yeah, he has Crohn’s disease. He’s failed medical treatment so he’s getting his colon removed.”

“But what if it recurs? Crohn’s disease can pop up anywhere in the intestines, and they can’t take it all out,” Fitz said.

“I read that it has a very high recurrence after surgery,” Simmons said.

Skye felt annoyed. “I don’t think he has any other options. They’re trying to fix the problem.”

Fitz and Simmons both looked worried. “We should stop by after rounds and say hello,” Simmons told Fitz. He nodded.

When they got to Dr. Hall on rounds, Ward started shaking his head halfway through Skye’s presentation. She was used to his disappointment in her presentations by now, but he surprised her at the end when he only said, “I hate these surgery dump cases. Good job though, Skye.”

Coulson nodded. “It’s frustrating,” he agreed.

“I don’t see what the problem is,” Skye admitted. “I mean, he has a medicine problem, right? Dehydration and a urinary tract infection. We’ll fix it in a couple of days and then he can go to surgery.”

Coulson shook his head. “We’re not their babysitters. They should know how to treat these things too. It’s not difficult.”

“Just make sure you talk to the surgery team every day. Twice a day if you can. I don’t want them to forget about him,” Ward said.

“Let’s go see him,” Coulson said.

As soon as they opened the door though they were greeted by an angry, “Go away.”

“It’s your doctors, Dr. Hall. We’re coming by to round on you,” Skye said.

“I know how rounds works. I am a doctor. I’m not in the mood. Come back later.”

Skye looked apologetically at Coulson and Ward who shrugged.

“All right, sir, we won’t bother you. Dr. Ward and I will be back to check on you later,” Coulson said.

*****

After lunch Fitz and Simmons decided to go visit Dr. Hall. They found him eating Jell-O in a somewhat better mood than he had been earlier.

“Hello Dr. Hall, do you remember us?” Fitz asked.

“We were in your pathology class a few years ago,” Simmons said.

“Of course, Jemma, Leo. You were two of the best students I ever taught.”

Simmons and Fitz beamed.

“How are you feeling?” Simmons asked.

“We heard that you weren’t doing well,” Fitz added.

“Hanging in there. My surgery’s been delayed though.” He sighed. “I want this to be over.”

“Fitz and I were so worried when we heard about your surgery,” Simmons said.

“That’s a drastic step,” Fitz said.

“They’ve tried me on every medicine that is approved for Crohn’s disease. Nothing works anymore.”

“But what if it comes back?” Simmons asked.

Dr. Hall did not look concerned. “Everybody dies,” he said. “I only want this surgery to buy me a little peace before the end.”

Fitz and Simmons exchanged a horrified look. “But Dr. Hall, there has to be another option -”

Dr. Hall shook his head. “I’ve made my decision. I’m tired now. Thank you for stopping by.”

Once they were in the corridor Simmons turned to Fitz. “I don’t like this Fitz.”

“I know. There has to be something we can do.”

“Maybe there’s a treatment that he hasn’t tried yet.”

Fitz nodded. “They do a lot of clinical trials here. There has to be something.”

*****

Ward was surprised when Fitz and Simmons dumped a pile of articles on the desk next to his computer.

“What’s this?”

“These are some new trials for treating Crohn’s disease,” Fitz said.

“We found some fascinating developments. Some of the trials running here have very promising results,” Simmons said.

Ward looked confused. “What are you talking about?”

“Dr. Hall,” Simmons said.

“We want to offer him a medical option instead of getting surgery,” Fitz said.

Skye came into the office. “What options?”

“We looked up some new medical treatments for Crohn’s disease for Dr. Hall,” Simmons said.

“We want to give him all the options before he goes to surgery,” Fitz said.

Skye sounded annoyed as she said, “I’m sure someone already did that before they scheduled the surgery.”

“It doesn’t hurt to go over it again,” Ward said.

“The surgery team is ready to take him to the OR tomorrow,” Skye said.

Simmons looked concerned. “Can we delay it? Just so that we can present the information to Dr. Hall, and he can review it.”

“The schedule is tightly booked. There’s not another spot until next week.”

Ward said, “Talk to the surgeons. They can figure something out.”

Once Fitz and Simmons had left Skye said, “Mr. Hall is my patient not theirs.”

“They’re only trying to help.”

“But this isn’t helping. I don’t know why we’re wasting so much time finding medical options. He’s getting surgery. He only came here so that we could hydrate him and treat a urinary tract infection.”

“Just because he came in with a plan doesn’t mean that we stop thinking. We owe it to every patient to give them the best possible care.”

“This is the best care. This will fix the problem.”

Ward looked disappointed. “It’s not that simple. The surgery has risks and complications. If we can spare him that with a new medicine, we need to offer him it.” He paused as if choosing his words carefully. “I was talking to Coulson about you. You’re doing better than I thought you would, but I feel like your heart is not really in medicine. Fitz and Simmons are here because they want to be researchers, but I don’t know why you chose this place. What do you want?”

“I got in through the scramble,” Skye admitted.

“I know that. But why did you chose S.H.I.E.L.D. instead of someplace else?”

Skye did not want to admit that it was to be closer to Miles, who was an emergency department intern at UVA, and because she thought it would be easy enough that she would have time to reapply to surgery. “I don’t know.”

Ward looked like he did not believe her. “Whatever your reasons, you’re here now. You need to dedicate yourself to medicine, and medicine requires a lot of commitment. It helps to remember what drove you to be a doctor in the first place.”

In truth it had been her father who had driven Skye to be a doctor, but she did not want to admit that either. She was curious though about what motivated Ward to always be the perfect robot doctor. “What drove you?”

Ward looked away, and Skye was not sure that he was going to tell her. Finally he said, “Growing up my younger brother was very sick. I want to take care of people the way that his doctors took care of him.”

Skye wanted to ask him what had happened to his younger brother, but the look on his face deterred her. Instead she just said, “Having a sick brother must have been hard.”

“It taught me that patients deserve everything we can do. No matter how much work that means for us.”

*****

Skye paged the surgery team twice to let them know that they wanted to delay the surgery, but no one paged her back before the team went to talk to Dr. Hall. Fitz and Simmons looked disappointed that they would not be able to discuss the treatment options with him, but Fitz was on call that day, and Simmons had a patient who needed a spinal tap. In the office they handed her the stacks of research papers.

“Now don’t forget to point out the favorable results in this 2012 trial by the group at Mayo -” Simmons began, but Fitz interrupted.

“That’s not the trial from Mayo. That’s the trial from MGH. They were using a similar agent but at a lower dose.” He put another paper on the pile. “This is the Mayo trial, and it’s pretty much the exact same protocol that Dr. Rogers is doing here.”

“ - but Dr. Hall will want to see all the data, so here is an unfavorable trial from a group in Japan -” Simmons said handing her another paper.

Coulson looked amused. “Jemma, Leo, one at a time. We will give Dr. Hall an overview then leave the papers with him to look through on his own. Thank you for all your hard work.”

Fitz nodded. “Thank you sir.” His pager went off, and he excused himself to go admit a new patient.

Ward came into the office. “Ready Jemma?” She nodded. To Coulson he said, “I’ll meet you in Dr. Hall’s room as soon as I can.” Ward and Simmons left to do the spinal tap together.

When Coulson and Skye arrived in Dr. Hall’s room they found a very angry surgery resident waiting for them.

“What is this about delaying the surgery?” the surgeon demanded.

“We need a little time to discuss some other options with him,” Skye said.

“There are no other options. Dr. Quinn decided that weeks ago. He’s getting surgery tomorrow.”

“He’s our patient now. We will determine the best course of action with Dr. Hall and get back to your team if your services are required,” Coulson said.

“I paged Dr. Quinn. He’s in a case, but he should be out soon,” the surgeon said.

Coulson looked at Dr. Hall, who was lying against the pillows with his eyes closed. “Dr. Hall, Skye and I have some treatment options that we wanted to discuss with you.”

“I don’t want to discuss it any more.”

“Sir,” Coulson’s voice was kind but firm, “Jemma and Leo care about you. They found some promising medical treatments that you should at least consider.”

“This is ridiculous. We have to wait for Dr. Quinn,” the surgery resident said.

“What’s the harm in just talking to the patient now?” Skye countered.

Dr. Hall opened his eyes. “Enough. I’ll listen to what you have to say,” he told Coulson, “but I don’t want to listen to any more children bickering.”

Coulson nodded. “You can wait for Dr. Quinn down the hall,” he told the surgery resident. “Skye, go outside and wait for Ward.”

Once they were outside, Skye asked, “I paged you twice. Why did you ignore me?”

The surgeon sighed. “I was in the OR.” She looked at her pager. “I don’t have time for this. You and Dr. Coulson can deal with Dr. Quinn yourselves.” She walked briskly down the hall to the elevators without a backwards glance.

Skye had only been waiting for a few minutes when Dr. Quinn stormed up. 

“Do you want to explain to me why your team is holding my patient hostage?”

“We’re not holding him hostage. He’s our patient. We’re presenting him with all the options.”

“Medical options?” Skye nodded. Quinn scoffed. “He’s run out of medical options. If you reviewed his chart, you should have seen that. The only option is for him to have his colon removed.”

“Our team found an experimental treatment that might help him.”

“Might help him?” Then his tone softened. “You’re Skye, right? I remember you. You applied here for residency. You have a very impressive family lineage.”

“Thanks,” Skye said. She never knew what to say when people said that.

“I doubt someone like you wants to be in internal medicine forever. You’re probably planning to apply for surgery again later this year, right?” She nodded, and he continued, “Then you understand where I’m coming from. We’re surgeons. We fix things. We don’t just observe them. This is going to be an interesting case. You could scrub in on it. It would be a great opportunity for you to get a little glimpse into your future.” He could tell that she was considering his offer, and he added, “If you help me get this done, I can even put in a good word for you when you apply in a few months. It would really help your application.”

Skye could not deny that this offer was tempting. Her application was not going to be much different the second time around, and she was not sure if she would be successful. However she thought about what Ward had said about commitment in medicine and doing everything possible to help the patient. Ward, Coulson, Fitz, and Simmons thought that this medical option was the best thing they could offer. But she did not get the sense that Quinn felt the same way about the surgery. “I thought we were supposed to help the patient.”

He scowled. “This will help the patient.”

“But what if the disease comes back?” When Quinn did not answer right away she said, “This isn’t really a cure, is it?”

“No, but it will buy him some time. He’s dying, and there’s nothing that medicine or surgery can do about that. Dr. Hall understands that.”

Skye shook her head as Ward walked up behind Quinn. “Sorry, but I don’t think I can help you. I’m not ready to give up yet.”

*****

Inside, Dr. Hall was silent as Coulson presented the research that Fitz and Simmons had uncovered. “So what do you think?” Coulson asked.

Dr. Hall stared at the stacks of papers and sighed. “What’s the point?”

“This treatment could manage your disease without surgery. The results so far are very promising.”

“Manage it, but not cure it.”

“Surgery isn’t a cure either.”

“I know that, but it can buy me some time. I don’t have any illusions, Dr. Coulson. I know that I’m dying. I’ve tried so many treatments, and I’m tired of it. I’m tired of waiting and fighting, of hoping that the next one is going to work. You have no idea what this is like.”

“I do actually.” Dr. Hall looked doubtful. “I had a heart attack last year. I had to have a heart transplant to survive. Now I have to live with the reality that even with the best medications available, this new heart is not going to last forever.”

Dr. Hall did not look impressed. “On average, heart transplants last ten years. I probably don’t even have ten months.”

Coulson nodded. “That’s true. But we both have deadlines much shorter than the average person. That’s a hard thing to live with. This treatment could give you more time without significantly impacting your quality of life. Surgery means months of recovery, plus serious side effects.” He puts the files on the bedside table. “I know how hard it is to hang onto hope, but at least take a look at the research Jemma and Leo put together. If you’re interested, I can arrange for the GI fellow to come talk to you.”

*****

The next day on rounds Skye announced proudly, “Dr. Hall would like to talk to the GI fellow in charge of the study. I paged Dr. Rogers, and he said that he would be by later today.”

Coulson looked pleased. “That’s good news.”

Fitz and Simmons grinned. “What did you say to convince him?” Fitz asked.

“We discussed his options,” Coulson said. “He was very impressed by the research you had done. He asked if you could come by today so he could thank you.”

Ward finished scribbling some notes in his illegible scrawl. “Okay, next patient.”

*****

May knocked on Coulson’s open door. “You’re working late.”

He looked away from his computer and rubbed his temples. “I’ve gotten a little behind on paperwork.”

“Seems like you’re more than a little behind. You’ve had to work late every night for weeks.”

“You know how hard it’s been finding attendings to cover the wards,” he snapped. “If no one else does it, I have to do it.”

“No you don’t. I’ll split the time with you.”

He raised his eyebrows, but to her annoyance he did not look surprised. “You finally believe in what I’m trying to do here? Or are you just trying to keep me from working too hard?”

“Does it matter?”

He smiled. “I guess not.”

“I’ll cover the wards tomorrow. Go home and get some rest. You look like crap.”


	4. Second Chances

**Summary for the Chapter:**

> When Coulson’s former protege collapses due to a brain tumor, he and the team must convince her to seek treatment.
> 
> Based on Season 1, Episode 4, "Eye Spy"

Coulson sent an email to remind all of the residents and attendings to be done rounding in time to see Dr. Amadour’s talk, and he stopped by Medicine 616 on his way there.

“Are you almost done rounding with Dr. May? Where is she?” he asked.

“She went back to her office. We just finished up a few minutes ago,” Ward said.

“Good. You can come with me to Dr. Amadour’s talk. We’re fortunate to have her come talk here. She is doing amazing work at the Cleveland Clinic.”

“That’s where Dr. Stark trained,” Fitz said.

“Akeela has only been there for a few years. Before that she was at Hopkins. I knew her when she was a medical student and resident.”

Skye noticed how proud he sounded of her. “So she was like your protege?”

“I wouldn’t go quite that far. She was one of my medical students when I was chief resident. She was the best in her class.”

“What sort of work is she doing now?” Simmons asked.

“She does procedures to fix arrhythmias,” Coulson said.

Ward looked interested. “I read her paper a few months ago in Circulation about a new procedure to treat recurrent ventricular tachycardia. Very controversial.”

Coulson nodded. “That’s what she’s going to be talking about today.” He smiled fondly. “She always marched to the beat of her own drum.”

*****

The main lecture hall on campus was filled to capacity by the time the team arrived. Dr. Amadour was at the front of the room talking with Dr. Stark. When Dr. Stark saw them enter he motioned for Coulson to join him in the front. There were no other seats left, so the rest of the team wound up standing at the back of the lecture hall. They were surprised when Coulson walked to the podium and tapped on the microphone.

“Good morning. We have a very special guest today, Dr. Akeela Amadour. Dr. Amadour attended medical school at Johns Hopkins, where I had the pleasure of working with her, and then did her residency and fellowship in cardiology and electrophysiology there as well. After her training she moved to the Cleveland Clinic, where she is an associate professor. She is here to discuss a new method for treatment refractory ventricular tachycardia. Dr. Amadour.”

There was politely enthusiastic applause as Dr. Amadour took the podium. “Thank you Dr. Coulson.” Her face twisted into a grimace for the briefest of moments, and she paused and rubbed her eyes before continuing. “I have developed a new method for treating ventricular tachycardia whereby -” She trailed off again and gripped the podium tightly. Coulson stood and started to walk towards her when she crumpled to the floor. In a flash he was beside her, checking her pulse and respiration.

“Call an ambulance,” he shouted.

*****

Coulson smiled at Amadour as she opened her eyes. “Hello, Akeela. You’re all right.”

“Coulson?” She blinked and looked confused. “What are you doing here?”

“You collapsed at your talk. A head CT revealed a tumor pressing on your optic nerve.” He paused to allow the news to sink in, but she seemed unphased. “You don’t seem surprised.”

“It was diagnosed three months ago.”

“I see. What kind of treatment plan are you pursuing? Surgery?”

“The tumor is wrapped around the optic nerve. In order to take it out, I’d have to lose my eye.”

“What about radiation? I can ask a radiation oncologist to come down and talk to you.”

“I’ve had radiation treatment to shrink it, but they can’t do anything more.”

“So you’re just giving up?”

“I can’t lose my eye, Coulson.” She sighed. “When can I be discharged?”

His mouth hardened into a thin line. “We’d like to keep you here overnight for observation.”

“We both know that’s not necessary. If you won’t discharge me, I’ll sign out AMA.”

“Let us run a few tests,” Coulson said. “I’ll have a radiation oncologist and neurosurgeon consult with you.” When she frowned, he added, “Please, Akeela. Do it for me.”

She sighed. “Fine.”

*****

Coulson came up to the Medicine 616 office right as Skye was on her way down to the emergency department to admit Dr. Amadour.

“Who’s on call today?”

“Me. What’s up?” Skye asked.

“You’re going to get a new patient soon, Dr. Amadour.”

“I know. I already got the page. I was about to go see her.”

“She’s reluctant to be admitted, but I negotiated a plan for the admission. Consult neurosurgery and radiation oncology for their input on the case. They should see her today.”

Skye nodded. Usually he gave them and Ward the freedom to decide on the plan themselves before he threw in his thoughts. The fact that he was taking a more active role surprised her, but she did not want to let him down. “Sure thing.”

A few hours later though she had still not heard from the radiation oncologist. It was well after lunch, and she was supposed to get a sandwich with Fitz and Simmons. Fitz was very excited because the grilled cheese sandwich truck was parked outside the hospital that day. 

“Come on Skye. They’re going to run out of sandwiches if we don’t hurry,” Fitz said.

“What else do you need to do?” Simmons asked.

“I’m just waiting to hear back from the radiation oncologist and the neurosurgeon. I paged them hours ago. The neurosurgeon said that he’d page me once he talked to her, but I haven’t heard from the radiation oncologist. I’ve paged twice already.”

“So tell her to page your cell phone and take it with you to get a sandwich. This truck won the Tale of Two Cities Baltimore-DC Food Truck Rally last year,” Fitz said.

Skye’s stomach growled as she thought about a gourmet grilled cheese sandwich. “Can you just get me one and bring it back? Coulson wanted me to get this consultant to see Dr. Amadour today.”

“Why can’t it wait until tomorrow? It’s not an emergency. Dr. May hasn’t even seen the patient yet,” Fitz asked.

“Is May going to be the attending? It sounds like Dr. Coulson is in charge here,” Simmons pointed out.

Skye shrugged. Before she could say anything else her pager went off. She was hoping that it was the radiation oncologist, but it was Dr. Amadour’s nurse.

“Crap.” Skye grabbed her coat and hurried out the door.

“What’s wrong?” Simmons asked.

“Dr. Amadour’s asking to leave against medical advice.”

Fitz and Simmons exchanged a look and hurried after her. When they got to the room sure enough Dr. Amadour was completely dressed and pacing around her room irritatedly.

“I want to leave. I spoke to the neurosurgeon, and he told me the same thing I heard in Cleveland. I’m not interested in treatment.”

“Did the radiation oncologist come by?”

“No. And I’m not going to wait around for him. I have a plane to catch.”

“Please. Just wait for the radiation oncologist. Dr. Coulson thinks it’s important.”

Dr. Amadour shook her head. “I can’t stay here just to appease Coulson. He’ll understand.”

Thinking about the way he had come to talk to her about Dr. Amadour’s case Skye said, “I don’t think so. He cares a lot about you.”

“I know my rights, and I’m leaving. So either give me an AMA form to sign, or I’ll walk out without it.”

“Hang on, just a second. I’ll be right back with that form.” As soon as she was back in the hall she went to the computer to page Coulson, but on her way she ran into May.

“Can you talk to Dr. Amadour?” Skye asked. “Coulson wants her to stay and talk to a radiation oncologist, but I can’t get someone to call me back, and now she’s trying to leave AMA.”

May nodded and followed her back to Amadour’s room. “You want to leave AMA?” May asked Amadour.

She nodded. “I understand my condition, and I don’t want to be treated here. I want to go home.”

“I was told you’re waiting for a radiation oncology consult.”

“Coulson insisted. But I’ve already spoken to a radiation oncologist at Cleveland Clinic. I doubt this one will tell me anything different.”

May nodded. “Probably not. I reviewed your case, and the standard treatment for this type of brain tumor is surgery followed by radiation therapy. To my knowledge there are not any experimental trials at the time that you would qualify for. You already spoke with the neurosurgeon?”

“Yes, and I’m not interested in having surgery right now. I want to leave.”

May nodded again. “There’s no need for you to leave AMA. I’ll discharge you.”

“But Coulson -”

May silenced her with a look. “Do the discharge paperwork.”

“Coulson’s not going to like this,” Skye said.

“He can talk to me about it.”

*****

Simmons, Fitz, and Skye all jumped when Coulson marched into the office. “Skye, where is Dr. Amadour?”

Skye flinched. “She left.”

“Did she talk to the specialists?”

“She talked to the neurosurgeon, but I never heard back from the radiation oncologist.”

May came into the office. She frowned at Coulson. “What’s going on?”

He spun around to face her. “I’m trying to find out why one of our patients left when she has a very serious tumor that needs immediate treatment.”

“I discharged her.”

“You did what?” The interns had never heard him so angry, and they all recoiled slightly.

May crossed her arms. “I discussed the treatment options available. She wasn’t interested in receiving treatment and wanted to leave.”

“Even though I had arranged for a radiation oncologist to come down and meet with her -”

May glared at him. “She understood her options. Her mind was made up. It’s her decision to make, and I didn’t have any reason to doubt her capacity.”

“Did you at least find out where she’s going?”

“Back to Cleveland.”

He checked his watch. “What time did she leave?”

Skye piped up, “I brought her a prescription for some pain medication right before she left. That was about thirty minutes ago.”

“I might still be able to catch her at the airport.”

“Phil,” May said, “you have to let it go. This is her decision.”

“She’s one of our own. I can’t just let her throw her life away.”

They stared at each other for a moment. Finally May said, “I’ll call Tony’s office. He’ll have her flight information.”

He nodded. “Call me when you get it.”

But by the time he got the call, it was too late. “Her flight’s in twenty minutes. I’ll never make it.” Silently he cursed DC traffic.

“Are you coming back?”

“I can’t. I have to try.”

As soon as May hung up, she called Stark’s office again. “I need Dr. Amadour’s number.”

Amadour sounded surprised to hear from May. “How did you get this number?”

“Phil is on his way to the airport,” she said. “He wants to talk to you.”

“I don’t have anything to say to him.”

“Listen to him. He cares about you, and he’s killing himself trying to help you.”

“I’m going back to Cleveland tonight. I have to get back to work.”

“Without treatment, you won’t be able to work much longer. Talk to him.”

Amadour sighed. “All right, I’ll talk to him.”

*****

Coulson had been sure that Amadour would already be in the air by the time he arrived at the airport, but instead she was standing near the check-in counter waiting for him. They went to a coffee shop to talk.

“Why are you doing this, Coulson?” she asked.

“Why are you? With surgery and radiation, you could live a normal life.”

“With only one eye. I can’t do procedures or research with just one eye.”

“That’s what this is about? Work?”

“You were the one who taught me that being a doctor takes dedication and sacrifice. I’m working on an important study. It’ll be finished in a few months. I can’t let anything jeopardize that.”

“The tumor will only continue to grow. In a few months removing it could be more dangerous or even impossible.”

“When you were chief resident and a fellow, you always put your work first. I admired that.”

“It cost me a lot. My marriage. My health. A year ago I nearly died. Now I have to live with that every day.” His tone softened. “There are more important things than work and research. Your health, your life.”

“Research is my life.”

“It doesn’t have to be. You can find other things. And even if you have the surgery, that doesn’t have to mean the end of your research career. You can still design experiments and supervise a lab. You can teach.”

She shook her head. “This doesn’t sound like you, Coulson. The Coulson I knew would have understood why I was making this choice.”

“I’ve changed. I almost worked myself to death, but the doctors here saved me, gave me a second chance. Let them help you. Don’t give up on your life.”

Amadour sighed. “I’m not sure what kind of life I’d have.”

“It will be different,” he admitted. “But you’ll adjust.”

“How did you know what to do with it? With your second chance?”

He smiled a little sadly. “I’m still trying to figure that out.”

*****

The next day Skye stopped by Coulson’s office after rounds. “Dr. Amadour is being transferred up to surgery today,” she said. “They’ll do some extra imaging, and her surgery is scheduled for the end of the week.”

“Thank you for letting me know.”

“What you did was pretty cool. Going after her like that.”

“I got a second chance. It seems only fair that I try to help others get one too.”

Skye smiled. “Like me. You took a chance on me, taking me in the scramble.” He nodded. “Well I’ll try not to let you down more any more than I have.”

He smiled. “You haven’t let me down yet.”


	5. Fix You

**Summary for the Chapter:**

> The residents treat a patient who is eligible for an exciting new drug trial but realize that the doctor running the trial is hiding something  
> Based on Season 1, Episode 5, “The Girl in the Flower Dress”

Skye re-read the email from Miles and wondered what to do. Her applications for surgery residency were due soon, and despite how hard she had been working at S.H.I.E.L.D. and how much she had learned, nothing she had done this past year would make her a stronger surgery candidate than she had been last time. Even if she applied to a much wider range of programs, there was no guarantee that she would be successful this time around.

She had written Miles an email freaking out about this a few days ago, and last night she had gotten an unexpected reply.

_I know some of the surgery residents here, and they talked to their program director about you. He did his training with your dad and has agreed to meet with you on Friday._

Meeting with the residency director in person would definitely help her chances this time around. He might even offer her a position outside the match. Plus if she got into UVA then she would be with Miles. Even though they were only two hours away, their busy schedules had made it impossible to see each other so far.

It seemed like a no brainer, but the problem was how to get the time off. The surgery program director wanted to meet with her Friday morning, and she had no one to cover her patients. It was not as if she could be honest with her team about why she wanted to the day off.

In the end she simply pretended to be sick. That day at work she had complained several times about a headache and sore throat so that Ward would not be surprised when she called that night and said, “I don’t think I’m going to make it in tomorrow.”

“Yeah, you didn’t look so good today. All right. I’ll let Coulson know. Fitz and Simmons can cover for you tomorrow.”

Skye felt a pang of guilt but shrugged it off. This was for her future.

*****

When she finished meeting with the surgeon she found Miles was waiting for her. “How’d the interview go?” Miles asked.

“Okay, I think,” Skye said. “We talked a lot about my dad.”

“Of course. He wants to hear all about that fancy family of yours.” Skye grimaced, but Miles did not seem to notice. “How about lunch before you go?”

“Sure.”

“It’s great to see you. I’ve really missed you,” Miles said after they had gotten their food. “I thought that one benefit of being at S.H.I.E.L.D. would be that we could see each other sometimes.”

“I’m sorry. I’ve missed you too, but you would not believe how crazy it’s been there,” Skye said.

“You know if you’re here next year we can see each other all the time. We could even live together.”

“Yeah well, we’ll see if I get an offer. Last year I didn’t get any, remember?”

“What’s it like anyway? I thought you picked S.H.I.E.L.D. because you thought it’d be easy, but every time I call you, you say that you’re swamped.”

Skye did not know how to describe it. “It’s not what I thought it would be like. We have a new residency director, Dr. Coulson, and he’s making the program a lot more intense.”

Miles made a face. “That sucks. Do you have some time off coming up? Even just a weekend off? We could go up to New York for a few days and take in the sights.”

Skye shook her head. “Not for a while. When we’re on the wards, we only get one weekend day off a week.” She wanted to say more about her time at S.H.I.E.L.D., how intense it was but in a good way, but before she could she spotted May on the other side of the cafeteria. “Crap,” she muttered, ducking her head.

“What?” Miles asked.

Skye motioned for him to be quiet. She prayed that May had not seen her, but just as she was about to look to see if May was still there, she heard a voice from behind her.

“Skye.”

Skye looked up and saw May standing over her. She looked furious. “Does Coulson know you’re here?”

Miles looked confused. “Excuse me, but we were having a private conversation.”

May ignored him. “What are you doing here?”

When Skye did not answer Miles said, “She had an interview for a surgical residency.”

May gave her a look, and Skye flinched. “You know I’ll have to tell Coulson about this,” May said.

Skye nodded weakly, but May turned and left without waiting for her response.

“Who was that?” Miles asked.

Skye stared at her food and tried not to cry. “My boss. And now I’m totally screwed.”

*****

She expected to find an angry page from May or Coulson waiting for her when she got home, but when she checked her pager there were no messages. All night she worried about what he would say the next time she saw him. She did not know what would be worse - anger or disappointment.

When he arrived for rounds though he did not even acknowledge her.

“Ready?” he asked Ward. When Ward nodded he walked out the door to the first patient’s room.

“Jemma and Fitz, tell Skye what happened with Mr. Chan when she was gone yesterday,” Coulson said.

Fitz and Simmons exchanged a confused look at the uncharacteristic sharpness in Coulson’s tone.

Fitz said, “There have been some fascinating developments with Mr. Chan.”

Skye had admitted Mr. Chan on her last call night with bleeding due to low platelets because his body was destroying them. “My guy with TTP. Did hematology ever come by?”

“Yes, Dr. Nichol came by yesterday. Because he has failed other treatments in the past she wants to enroll him in a clinical trial,” Fitz said.

“Dr. Nichol has had some amazing results. Fitz and I were reading some of her studies. She published a study not long ago looking at the use to rituximab and prednisone for the treatment of refractory TTP,” Simmons said.

“That’s great news,” Coulson said. “Otherwise I’m not sure what we could do for him.”

Skye could not contain herself any longer. “Coulson, about yesterday -” she began, but Coulson silenced her with a raised finger.

“We’re rounding Skye. I’ll talk to you later.”

*****

After rounds though Coulson went to a meeting before Skye had a chance to explain what had happened. She circled back to talk more with Mr. Chan about the study, and he was very excited.

“I’ve been told so many times that my disease is incurable, and I’ve run out of options. I’m glad I came here.”

“That’s the great thing about a place like S.H.I.E.L.D.,” Skye said. “There are always new possibilities.”

When she returned to the office Fitz and Simmons were looking over Dr. Nichol’s paper.

“Hey guys, what’s up?” Skye asked.

“We were going over Dr. Nichol’s paper so we could present it for journal club in a few days, but there’s something unusual… ” Simmons trailed off.

“An irregularity in some of the data,” Fitz jumped in.

“What do you mean?” Skye asked.

Fitz and Simmons started thrusting papers under her nose. “Well I first noticed it in this study, the mortality rate seemed abnormally high, so I compared it to this study done two years ago at the Mayo Clinic -”

“And this one at UCLA from three years ago -”

“Guys,” Skye interrupted, “what’s your point?”

“The mortality rate for all of her control groups is higher than the historical averages,” Simmons said.

Skye frowned. “What does that mean?”

“I’m not sure,” Simmons said.

“If it were just one or two -” Fitz said.

“- but it’s all of them. I think she might be biasing the data somehow.”

“How? It’s a double-blinded study.” Skye studied the methods paragraph. “What do they mean by standard therapy here? I thought that if you don’t respond to pheresis, there was no other standard treatment.”

“That’s true. In most of these studies, standard therapy just means a few rounds of pheresis to treat acute flares and blood transfusions as needed.”

Simmons stared at the first page of the results section. Like in all clinical trials there was a large table of demographics comparing the two study populations. Even in a perfectly randomized trial it was impossible to get two identical groups, but in this study they seemed too different. “Fitz, pull up the demographics tables from the other studies from Dr. Nichol’s group.”

“Why? What are you thinking of?” Fitz asked as he pulled those pages out the stacks of papers to compare them side by side.

“Even before the study the control group has a more aggressive disease than the experimental group. See here. They were requiring more frequent transfusions, having more hospitalizations for flares.”

Fitz pointed to similar tables in the papers in front of him. “Same thing here, and here.”

“They’re sicker,” Skye said.

“And it’s not just their TTP. They’re sicker in general too. There’s a higher rate of diabetes, hypertension, stroke, heart disease,” Simmons said.

“That can’t be a coincidence,” Skye said.

“Why would somebody do that? The point of a randomized controlled trial is to compare the treatment in two identical groups,” Fitz said.

“Because if the groups aren’t identical, if the group not getting the drug is already sicker to begin with,” Skye said, “then the drug will look even better by comparison.”

Fitz and Simmons looked horrified. “But that’s unethical,” Fitz said.

“We have to tell Coulson,” Skye said.

*****

When Fitz and Simmons told Coulson about their suspicions, he did not know what to believe. He wanted to trust his colleagues at S.H.I.E.L.D. and the integrity of scientific research, but he also knew that Fitz and Simmons would never come to him with something unless they had the evidence. He decided that he needed to address this with Dr. Nichol. On his way to see her, he stopped at May’s office.

“Do you have a minute?” he asked.

May looked up from her computer. “What is it?”

“Are you familiar with Debbie Nichol?”

“Vaguely. She’s a hematologist here. Why?”

“She’s enrolling a patient of mine with TTP into her latest clinical trial, but Fitz and Simmons uncovered some irregularities in her previous studies.”

“What sort of irregularities?”

“They noticed that her control groups are always sicker than the treatment groups before treatment even begins.” He handed her the papers that Fitz and Simmons had printed out for him.

“Some of that is natural variation. No one is ever going to get two completely identical groups,” May said, but she looked doubtful as she read through the papers. When she was finished she nodded. “What are you going to do?”

“I was going to talk to her. Give her a chance to explain herself. Then go to the research ethics committee.”

“Do you think anything she’s going to say would change your mind about that last part?”

“Probably not. But I feel like I need to tell her face to face before I torpedo her career.” He looked uncomfortable, and she wondered if he had really come by only to talk.

“I’ll come with you,” May offered.

He looked relieved. “Thanks.”

*****

They found her in the hematology clinic seeing patients.

“Dr. Nichol, can we have a word?” Coulson asked.

“I’m sorry, I’m in the middle of seeing patients for my study. Can it wait?”

“It’ll just take a minute,” he said.

“Okay.” Nichol looked confused but gestured towards an empty exam room. “Why don’t we go in here to talk?” May and Coulson followed her into the room and were sure to shut the door behind them. Seeing their grim faces the polite smile fell from Nichol’s face. “What’s this about? Who are you?”

“I’m Dr. Coulson. This is Dr. May. You’re enrolling one of my patients in your clinical trial for TTP.”

“Is this about Mr. Chan? We’ll probably be able to start him on the protocol sometime next week. If you give him a transfusion, he’ll be fine until then.”

“This isn’t about Mr. Chan. It’s about your trial. My residents and I looked through your papers, and there are some disturbing patterns that call into question the validity of your trials.”

“Your studies are not truly blinded,” May said flatly. “You only give the treatment to the healthiest patients and use the sicker ones as the control group.”

Nichol flushed with anger. “How dare you pull me out of my clinic to question my research integrity based on something the residents found.”

“My residents are very astute,” Coulson said.

“You have no proof,” Nichol snapped. “My research is of the highest caliber. I am treating a disease for which there are no other options. I am trying to cure thousands of patients.”

“By lying about the results,” Coulson said.

“If you had any real evidence you would file a complaint with the research ethics committee. Now, I have patients to see.”

“That’s our next stop.” May said.

Nichol turned and marched out without another word.

*****

The next day Fitz and Simmons pounced on Coulson as soon as he walked through the door.

“What happened with Dr. Nichol?” Simmons asked.

“We got an email that said that all of her clinical trials have been suspended pending a formal investigation,” Fitz said.

“And the pharmaceutical company that she works with has pulled their support,” Simmons said.

“She denied any wrongdoing, but I reported what you found to the research ethics committee. They’ll hold formal hearings, but with her collaborators turning against her it doesn’t look good for her career,” Coulson said. “We need to tell Mr. Chan that he won’t be able to enroll in the trial after all.”

“He’s not going to like that,” Skye said.

As she predicted, Chan was livid when he heard the news.

“What are you saying? I thought you said that this trial was my only treatment option.”

“It was, but enrollment has closed.”

“Open it back up.”

“I’m afraid we can’t do that.”

“Why not? This is my life!” When he did not get a response from Coulson, he demanded, “I want to speak to Dr. Nichol. She said I was the perfect candidate.”

“I’m afraid that she is no longer apart of the trial.”

Skye did not know if it would help, but she said, “The trial has been suspended.”

Chan looked confused. “Suspended? Why? Do you mean the treatment didn’t work?”

“We don’t know. It may work.”

“Then give it to me. I need something or else this disease will kill me.”

“You weren’t guaranteed to get the treatment. You might have been in the placebo group,” Fitz said. “That’s the way the study worked.”

“Dr. Nichol explained that to me. But half a chance is better than no chance. What are you saying? That you have nothing to offer me?”

“We have given you a platelet transfusion to stop your bleeding, and we are going to arrange pheresis to treat this flare.”

Chan shook his head. “I’ve been through pheresis so many times. It never lasts for long. I need a cure.” When he saw their blank faces he stood abruptly. “If you can’t give me that, I’m going to go someplace that can.”

Coulson tried to get Mr. Chan to sit back down and talk about it rationally, but he was too upset. He shouted for them to leave him alone if they were not going to treat him so he could get dressed.

Out in the hall Ward looked grimly at Coulson who was staring morosely at Chan’s closed door.

“You can’t save everybody sir,” he offered.

Coulson shook his head. “I’m going back to my office. Page me if anything comes up.”

*****

Skye almost thought that Coulson had forgotten about her visit to UVA when she got a page from him to come to his office after work. When she got there he was sitting behind his desk staring at his computer.

“When Dr. May was giving a talk at the University of Virginia a few days ago, she saw you there interviewing for a surgical residency position.”

Skye nodded.

“Is that what you want?”

Skye stared at the floor.

“I knew that you didn’t set out to go into internal medicine, but I thought you showed real potential. I took a chance on you, accepting you into this program. But you’ve been lying to me the whole time. What is it you’re doing here?”

She still could not meet his eye. “I thought that I would reapply this year and go somewhere else for surgery.”

“Then why come here in the first place? You took a spot away from someone else who would have gotten something out of this program instead of wasting our time.” When she did not answer right away, Coulson said, “You need to start telling the truth, or I’m done with you. I don’t have time to play games, Skye. I have patients to take care of and residents to teach.”

She felt stupid admitting the truth out loud. He was not the first person to ask why she had taken the position at S.H.I.E.L.D. instead of just taking a year off. She had not even admitted the truth to her father. “My dad was here for his training when I was a little kid. Before my mom left. I thought - I thought by being here I could find out what happened to her.”

His expression did not soften as he said, “What do you mean?”

“She left when I was a kid. I never found out why.” She swallowed and tried to keep her voice for cracking. “I tried talking to some of the surgeons here when I first arrived, but none of them would talk to me about her.”

“Maybe I can help. But you may not like what you find out.”

Skye nodded gratefully. “What I said earlier - I thought that I would re-apply in surgery this year, but now I’m not sure. I like internal medicine more than I thought I would. I used to think medicine was about fixing problems, cutting people open. But I really like figuring out the problems and getting to know the patients.”

Coulson looked coolly at her. “I need to know whether I should be looking for a new resident to fill your spot.”

Skye shook her head. “I want to stay.”


	6. Infection

**Summary for the Chapter:**

> The team treats a man with a serious pulmonary disease, and Dr. Simmons finds herself personally affected.  
> Based on Season 1, Episode 6,“FZZT”

Simmons could not contain her glee when she presented her new patient on morning rounds. Despite having been awake for 24 hours, she was bright-eyed and chattering excitedly to the team.

“How much coffee have you had?” Skye asked.

“None! Why?”

“Did you get any sleep last night?”

“Almost a whole hour. I feel great.”

Skye smiled. “Okay,” she said somewhat skeptically.

“And look at the CT scan!” she said. She pointed at the images. “It’s absolutely amazing. He has all this ground glass consolidation here and here, and then these cysts and more fibrotic looking changes over here. I’ve never seen anything like it before.”

Ward took the mouse from her and scrolled through the images. “Interesting.” 

Beside him May, who was their attending that week, did not look excited. “What’s your diagnosis?”

“Well it could be an interstitial lung disease such as BOOP or IPF or LAM, although I don’t believe there’s ever been a case of LAM in a male before. I also read that lymphangitic spread of a malignancy -”

Ward interrupted her. “Start with common things. What about an infection?”

“I suppose it could be, but the CT does not look classic for a bacterial pneumonia. Maybe something viral or atypical like mycobacterial, or - oh! It could be sarcoidosis -”

“Does he have HIV?” May asked.

“I didn’t ask,” Simmons admitted. “He doesn’t have any risk factors.”

“First law of medicine: all patients have HIV unless proven otherwise,” Ward said.

“That doesn’t seem fair,” Skye said, but May cut her off.

“Let’s see the patient.”

When they got to the room they found that the patient looked terrible. He was pale and clammy and gasping for breath despite being on maximal supplemental oxygen. 

Ward put an oxygen probe on his finger. The oxygen saturation was only 85%.

“Ward, call the ICU. Skye, get a blood gas,” May said.

Simmons jumped at the opportunity. “I can do it. He’s my patient.” Skye had already grabbed a kit, but she handed it to Simmons. Simmons wiped down the patient’s wrist and held it tightly as she maneuvered the long needle. She was trying to hit one of the arteries that ran to one side, but she missed twice before it started to fill with blood.

“Got it,” she said. She moved to recap it, but as she did so wound up sticking the thumb on her other hand. “Ouch.” She stared dumbly at the torn spot on her glove. A bead of blood welled up, and she did not know whether it was hers or the patient’s.

From her spot at the patient’s side May had seen the whole thing.

“You need to report this. Go to occupational health,” May said.

“What about my patients?”

May shook her head. “Fitz and Skye will cover them. After they evaluate you in occupational health, go home.”

*****

When Fitz got home that evening he found Simmons staring at the television blankly.

“I thought you’d be asleep already.”

“I couldn’t sleep.”

Fitz sat down on the couch next to her. “What did occupational health say?”

Simmons’ voice was oddly high pitched as if she were trying to sound cheerful. “The patient’s rapid HIV test came back positive. But overall they say that my risk of getting HIV is actually quite low. Just in case they do want me to start antivirals right away. I’ll have to take them for six months and get tested regularly to see if I contract the virus.” 

“Well that’s good news.” Fitz tried to sound cheerful but knew he was failing. “I’m sure everything’s going to be fine. Nothing to worry about.”

Simmons’ phone rang, but she just stared at the words “Mum and Dad” across the screen.

“Aren’t you going to answer that?” Because of their work schedules and the time difference Simmons had not talked to her parents in several weeks.

Simmons looked guilty but shook her head. “I don’t know what I’d tell them. I don’t want to worry them until I know for sure.”

“But that could be six months from now. You have to talk to them before then.”

Simmons shook her head. “I’m tired. I’m going to go lie down.”

*****

Coulson was surprised to see May standing in his office.

“I’m worried about Jemma Simmons,” she said.

He turned his attention away from the medical report that he had been staring at for the past hour. “What’s going on?”

“A few days ago she stuck herself with a needle that had HIV-positive blood on it.”

“Did she got to occupational health?”

“Yes. They set her up with antivirals and monitoring, but she hasn’t been herself since. She barely talks on rounds, and she always looks depressed.”

“She’s not going to feel better until her six months of waiting are up. But I can talk to her. It’s a hard thing to deal with - our own mortality.” He looked down at the medical report again.

“Is something wrong?”

He shook his head. “Everything’s fine.”

“What are you looking at?”

“My records. I had a checkup with Tony Stark a few days ago. According to this everything’s fine.” She crossed her arms and waited for him to continue. Finally he admitted, “But I don’t feel fine. I feel different. Tired. Slow.”

May’s expression softened. “You died, Phil. Your heart stopped while you were in the ICU, and they had to shock you twice to bring you back. You were on life support for weeks and then had a transplant. There’s no way you can go through something like that and be exactly the same as you were before.”

“It used to be that I never got sick. I didn’t miss a single day when I was chief resident. But thanks to all of the immunosuppressants I have to take, I’ve been out with a cold four times this year.”

“Those medications are keeping you alive,” she reminded him.

“I know.” It felt so strange being on the other side of medicine. He was used to be the one giving the lectures on the importance of taking your medications and eating right. Now he was the one getting the lectures.

She looked sympathetic. “You may feel different, but you’re still here. You’re still Phil Coulson.”

*****

Simmons tried to pretend that everything was fine. She knew that everyone was worried about her. Coulson had called her into his office for a pep talk, and even May was being patient with her on rounds. Fitz and Skye seemed to sense the overwhelming anxiety she felt every time a procedure came up, and they took turns jumping in to do them for her. She felt guilty about having them do her work for her, but the thought of being in another situation where she might get stuck filled her with dread. What if she were exposed to another infection? Or worse if she exposed the patient to her blood? Despite the reassurances of occupational health and her own research on the subject she could not shake the feeling that she was contaminated with HIV.

After a few days in the ICU Mr. Diaz was well enough to be transferred back to their service, and Ward assigned Simmons to continue caring for him. May's suspicions that his lung disease was an HIV-related pneumonia had turned out to be true, and in addition to treating the pneumonia they started him on anti-HIV medications as well.

“Keep an eye on him,” Ward told Simmons. “As we treat him he may get worse before he gets better.”

Simmons nodded. She wanted to ask if he could please assign the patient to Skye or Fitz, but she did not want him to think that she was shirking her duty. The first several days she checked on him frequently. He was still very weak and required a lot of supplemental oxygen, but he managed to hang on for two days before Simmons received an urgent page during journal club.

“Mr. Diaz, room 613, oxygen level 87% on maximal oxygen. Please assess.”

When Simmons got to the room he looked almost as bad as when they had sent him to the ICU before. It was taking all of his energy to keep breathing. He looked up at her panic-stricken and mouthed “Help me.”

Simmons froze. More than anything she wished that someone was there with her. Ward always knew what to do in an emergency, and for all that she complained about being dumb, Skye could stay calm under pressure. In contrast Simmons felt like her mind was full of a million random thoughts bumping into each other. She had no idea what the right thing to do was, but she knew that she needed more help, so she pulled the code bell to summon the code team from the ICU. The first person through the door was not the ICU fellow or resident, though. It was Ward.

“What happened?”

Simmons pointed at Mr. Diaz. “He can't breathe. He's on a non-rebreather, and his oxygen level is only 87%.”

She envied how he took in the situation in a second and nodded. “He needs to be intubated. The code team will do it once they get here. We need to make sure he has a working IV so they can sedate him for it.”

“He lost his IV earlier today.”

“Have you ever put one in?” Simmons nodded slowly. “Good.” He tossed her a IV start kit.

“Is that really a good idea?” She wondered if Ward could hear the fear in her voice.

“You can do this Jemma,” Ward said.

Something about the way he said it, firm but filled with confidence, made her put her protests aside.

He stood right beside her as she maneuvered the needle into the vein. The first time she missed she expected him to grab the needle out of her hand, but he was remarkably patient and gave her some pointers so that she got it on the second try.

The ICU team arrived as they were taping down the IV, and the ICU fellow quickly took over the situation, arranging transport to the ICU and intubating the patient. It did not take long before they were wheeling him back to the ICU leaving Ward and Simmons standing in the room.

“Good job,” Ward said. He looked alarmed when Simmons burst into tears in response. “What's wrong?”

She shook her head. She tried to tell him that she was fine, but she could not get the words out. She felt like a wreck after the pure terror of the past few minutes, not to mention the fear that had been lingering at the edge of her mind since she got stuck.

Ward looked like he would rather be anywhere else than in a room with a crying intern. “Come on, Jemma.” He led her down to the nurses' break room. There was a large table in the middle of the room and along one wall there was a coffee machine and a fridge. One of the veteran nurses was sitting in the room watching TV and eating lunch, but when he saw them enter, he quickly got up.

“I'll give you guys a minute.” On his way out he gave Simmons a reassuring smile and a pat on the shoulder.

Ward handed her a cup of coffee and waited for her tears to subside. When she had calmed herself enough to take a sip of coffee he asked, “What's wrong Jemma?”

She forced a smile. “Nothing.”

He shook his head. “None of us are buying that.”

She stared at her coffee. It was easier to pretend that everything was all right than to admit to herself that she was not. Ward was the last person she thought about baring her soul to, but she found herself admitting, “I knew you weren't.”

“Everyone's really worried about you, Jemma.”

Simmons mentally added that guilt to the pile in her mind. “I feel so – I feel like a mess. Guilty, scared, sad, angry.”

“Angry at the patient?” Ward asked.

Simmons looked at him horrified. It had never even occurred to her to blame Mr. Diaz for her mistake. “Of course not! At myself. It was my mistakes that put me in this position.”

“What mistakes?”

“I wasn't careful enough when I drew the blood gas.”

“That sort of thing happens. It's not your fault.”

“But I missed the diagnosis. I wasn't even close on rounds. If I had started the right treatment the moment he came in, this wouldn't have happened. He wouldn't have gotten so sick.”

Ward shook his head. “Jemma, you did everything right. Yes, you didn't have the right diagnosis on rounds, but that's the point of rounds. You're still learning. We're all still learning. But you did what you needed to keep him safe. This is a serious type of pneumonia. Patients can crash quickly, but each time you've done what you had to.”

“I didn't know what to do today. I pulled the code bell because I couldn't think of what else to do.”

“That was the right decision. Jemma, you need to stop being so hard on yourself. You're smart, smarter than me, but you're not always going to have the right answer in medicine. Nobody does. We're all figuring it out as we go, making decisions, and then making changes when we have to.”

Simmons nodded.

“Is this what's been bothering you this whole time? We all thought that it was the HIV scare.”

“Well that doesn't make any of this easier,” Simmons admitted.

Ward looked at her admiringly. “You're a good doctor, Jemma.” The way he said it told her that he was not referring to the number of questions she got right on rounds or how high her board scores had been.

“Thanks. You are too.”

“Even though I'm a robot?”

Simmons blushed. She and Fitz would do robot impressions of Ward in the office sometimes when just the interns were there. “You heard about that.”

In his best robot voice he said, “Ward-bot downloading comforting talk.”

When they got to the office they found Fitz and Skye talking, but they immediately fell silent when they saw them come in.

“Hi guys. What's going on?” Simmons asked.

Their guilty looks told her that they had been talking about her.

“Nothing. We heard about your patient,” Skye said.

Simmons nodded. “He took a turn for the worse, so we sent him back to the ICU. I'm going to go visit him later today. Do you want to come with me? We can all get dinner afterwards. Fitz and I found this adorable Ethiopian place in our neighborhood that we've been meaning to try.”

Skye smiled. “Sure. You look like you're feeling better.”

“I am.” Simmons smiled at Ward.

“Are you going to finally come out too, Ward?” Skye asked.

“Sure.”

“Really?” Skye pretended to pass out from shock.

“Come on. Let's finish up the discharges on your patients so we can get out of here at a decent hour.”

After they left Simmons noticed that Fitz was uncharacteristically quiet and moody in the corner.

“Fitz?” she asked.

“I didn’t know that you and Ward were such good friends,” Fitz said a little stiffly.

“What do you mean?”

“You're inviting him to dinner with us. And you were crying on his shoulder earlier. You know, you could have talked to me.”

“Oh Fitz.” She sat down in the chair next to him and put her arm around him. “I know. I realized that I haven't thanked you for everything that you've done for me the past few days - helping me out here at the hospital, taking care of me at home. I'm so glad we're best friends. I couldn't make it through this year without you.” She hugged him.

Fitz smiled. “Me too.”


	7. Brothers

**Summary for the Chapter:**

> The team cares for a young woman dying of kidney failure, and Dr. Ward is reminded of his younger brother who needed a bone marrow transplant.  
> Based on Season 1, Episode 8, “The Well”

**Notes for the Chapter:**

> We read that initially episode 1x08 "The Well" was supposed to come before episode 1x07 "The Hub" which made a little more sense in terms of the character arcs, and so we decided to parallel that here.

When Ward came into the office Fitz, Simmons, and Skye were already talking about one of the new patients that Simmons had admitted the night before.

“It's just so sad. She's so young,” Simmons said.

“How young? Should she be on pediatrics?” Ward asked.

“No, she's an adult. But she's only 19.”

“What's wrong with her?”

“She has an infection in her dialysis catheter.”

Skye shook her head sadly. “Can you imagine being only 19 and on dialysis?”

Fitz looked curious. “Why is she on dialysis? Does she have a genetic disease?”

“Juvenile onset polycystic kidney disease.”

“That sucks,” Skye said.

“Why does she have a catheter instead of a fistula?” Fitz asked. “She's going to be on dialysis for the rest of her life. Why not give her something more permanent ?”

“That's the thing. She's supposed to get a kidney transplant from her brother. Her mother said that they've been working her up for a while, but that there have been some delays. I didn't really get into it last night.”

At the mention of a transplant Ward stiffened involuntarily, but the others did not seem to notice. “We need to figure out the timeline of that,” he said. “That'll determine what we should do for dialysis in the meantime. If she's going to get the transplant in a few weeks we can put in a temporary catheter.”

*****

When they rounded on Petra Nystrom her parents and brother were not there yet, and she could not give a clear answer as to the plans for her transplant. In the afternoon Ward circled back around to see if they were there. Mrs. Nystrom was sitting at her daughter’s side, clutching her hand while Mr. Nystrom paced anxiously.

“You must be Petra’s doctor,” Mr. Nystrom said when Ward came in the room. “How is she doing?”

As Ward explained about the blood infection, which meant that they would have to remove her dialysis catheter while the antibiotics fought the infection, his attention was drawn towards a sullen-looking young man slouching in the corner. He had not even looked up from his video game.

“We heard that she is being evaluated for a kidney transplant from her brother. Has that been scheduled?” Ward asked.

Mr. and Mrs. Nystrom exchanged a look. Mrs. Nystrom said, “The work up has been completed, and Jakob is an excellent match, but there have been some delays.”

“What sort of delays?” 

Ward did not miss the angry look that Mr. Nystrom shot his son in the corner.

“Jakob loves his sister, but he’s a little nervous about the surgery,” Mrs. Nystrom explained.

“He’s going to do it,” Mr. Nystrom said. “The sooner the better.”

“It’s a big decision,” Mrs. Nystrom said.

Petra looked uncomfortable. “I’m doing okay on dialysis,” she said. “There’s no rush.”

Ward felt his stomach clench. It was all too familiar. He tried to sound calm as he said, “Why don’t we talk more about the surgery? We can answer any lingering questions.”

The parents looked at their son. “That would be helpful, thank you. Jakob, do you have any questions for the doctor?” Mrs. Nystrom said.

Jakob looked up from his video game. “I have to go to work,” he announced.

“The doctor needs an answer. You can’t keep putting this off forever,” Mr. Nystrom said. 

Father and son stared at each other. Mrs. Nystrom tried to break the tension by saying, “What about tomorrow? Jakob doesn’t have to work then. We can all be here in the afternoon.”

Ward nodded. “We’ll meet then.”

*****

Three sets of concerned eyes greeted Ward when he got back into the office.

“What’s wrong?” Skye asked.

“Nothing. Nystrom family meeting tomorrow after lunch.” He sat down at his computer and tried to ignore them, but Skye was not letting it go.

“Oh, I was going to go talk to them in a bit to schedule,” Simmons said sheepishly.

“It’s done. Don’t be late.”

“Something’s wrong,” Skye insisted. “You haven’t been acting like yourself. You’re all weird and tense.” Ward hoped that by ignoring her she would leave him alone. Instead she leaned over the desk. “Is it about your brother?” she asked quietly. “The one who needed a transplant?”

Ward regretted telling her about that. It was not something that he liked to think about. “Drop it,” he said.

“Grant, if you want to talk, I’m here for you.”

Her eyes were filled with concern, but it only annoyed Ward more. This was not anyone’s business but his own, and besides that, it had all happened so long ago. He had to bite his tongue to keep from saying something he would regret. Instead he grabbed his things and stormed out of the office.

*****

Ward found it difficult to concentrate during the meeting with the Nystrom family. He tried to focus on the conversation going on around him, but he kept flashing back to when his own family was in the Nystrom’s place.

When the Ward family had learned that the youngest son needed a bone marrow transplant to survive, they had tested all of his blood relatives. Grant and his parents were not matches, but Maynard was. Dr. Randolph had explained that Maynard was an excellent match, but they would need to make sure that he was in healthy going into the transplant. Even a small infection at the time of transplant could be fatal to his younger brother once he had received the chemotherapy that would decimate his cancer-ridden native bone marrow, allowing Maynard’s marrow to take over. Their parents had pulled Maynard out of school for a week prior to the transplant and refused to let him see anyone for fear that he would pick up an infection. Ward had taken it upon himself to monitor his older brother’s movements. Four days into his confinement, he had realized that Maynard had snuck out. When he had confronted Maynard, he had shrugged the incident off and told Ward not to tell their parents or else he would be sorry.

Then the day before the transplant, after a final set of lab work, they were all called into Dr. Randolph’s office. Ward remembered the grim face of Dr. Randolph when he told them that the bone marrow transplant was cancelled. His mother had gone very white, and his father had grabbed Maynard sharply.

“What did you do?” he demanded.

Dr. Randolph had cleared his throat. “It’s not what he did exactly. But his blood tests show that he is now positive for CMV. As we discussed earlier there is a high risk for serious complications if we transplant bone marrow into your son that carries the virus. Unfortunately we cannot postpone things until he gets over it. Maynard will carry the virus with him his entire life.” 

For a moment Ward had thought that his father was going to hit Maynard, but he had finally released his arm and paced around the room. Ward’s mother had begun to sob. Maynard had rubbed his arm defiantly but had not said anything. 

“Another match may still come up,” Dr. Randolph had said helplessly.

Ward found himself pulled back into the present when he heard Jakob Nystrom say, “But another match may still come up, right? It doesn’t have to be from me.” He looked hopefully at his parents and the doctors.

Without thinking Ward snapped, “Petra is your sister. You have a responsibility to protect her, to do whatever it takes to make sure she’s safe.”

“Dr. Ward,” May said sharply.

Jakob’s eyes narrowed angrily. “I love my sister, but you don’t know what you’re asking of me. This is my kidney. What if something happens to me? What if I get sick too?”

“Quit being selfish,” Ward said.

By the shocked look on Skye, Fitz, and Simmons’ faces he had said the last part louder than he intended.

Before the Nystroms could react, May said, “Excuse us a minute.”

Once they were all in the hallway, May sent the interns scurrying back to the office. She led Ward over to an empty alcove.

“What the hell was that back there?” she asked.

Ward did not feel like explaining everything with his brother. “He’s being selfish and cowardly. His sister needs his kidney to live, end of discussion.”

“That isn’t your call or my call.” She stared at him expectantly, waiting for him to say more, but he stuck his hands in his pockets and stared at the space above her head. “That was completely unprofessional behavior, Dr. Ward. I’m going to finish the family meeting. I’ll page you when I’m done.”

Ward knew that if he went back to the office he would have to face Skye, Fitz, and Simmons. He did not know if he could handle their concerned looks and probing questions. Instead he sat down at a computer in the hall to work.

May emerged from the family meeting a few minutes later. He expected her to yell at him again, but the first thing she said was, “Jakob will not agree to the transplant. He’s asking for more time. Arrange for Petra Nystrom to get a new permanent dialysis catheter and then discharge her.”

“What about her transplant?”

“The family is going to have to sort that out amongst themselves. She’s on a list for a transplant from an unrelated donor as well. Something may come up.” 

Ward clenched his fists. He knew how long she could be waiting for that, how many people died waiting on the transplant list. He forced himself to take a deep breath. “About what happened in the meeting, I’m sorry. That never should have happened.” 

She nodded. “Don’t compromise your professionalism.”

Normally he tried to maintain a clinical detachment from his patients. It helped him stay focused and objective. But this case was too close to what happened with his brother for him to do that. He wondered how May managed to remain so calm despite seeing dying patients every day as an oncologist. “How do you it? Not let yourself get emotionally invested in some of the patients.”

The look she gave him was almost pitying. “I’m emotionally invested in all of my patients,” she said before walking away.

*****

When they got off work that evening, Simmons, Skye, and Fitz went to the bar across the street. Ward was sitting at the bar, staring at a shot of whiskey.

Simmons and Fitz immediately went over to a table where some other interns were sitting, but Skye headed for Ward. She smiled and sat down next to him. “I thought I might find you here.”

He just stared at her coldly, then took a long sip of his drink.

“I thought I’d see how you were doing. I know this case really affected you, and I wanted you to know that I’m here if you want to talk.”

He looked at her. “I appreciate that. But I don’t really feel like talking right now.”

She tried to keep her smile in place, but his cold stare made her flinch a little. “Okay, well… I’m here if you change your mind.” She got up and joined the interns.

Ward finished his drink and ordered another, keeping his eyes fixed on the bar. He heard footsteps, and he steeled himself to deal with Skye again. But instead May sat down next to him.

“Macallan neat. Double.”

They drank in silence. When they finished May raised her eyebrows at him, and he nodded. “Two more,” she told the bartender.

“Sometimes this job…” he said.

She did not say anything, but her expression said that she understood. She tossed her drink back. “I have more at my place.”

He downed his and nodded. “Do you live near here?”

“Not too far. We can take a cab.”

His apartment was close enough to the hospital that they could walk there, but he was not sure how she would feel about going there. He barely had any furniture, and he could not remember when he last washed his sheets. “All right, let’s go.”


	8. A Guy Like You and a Guy Like Me

**Summary for the Chapter:**

> When a freak snowstorm hits the city, Ward and Fitz are stuck alone in the ICU. Meanwhile, the rest of the doctors struggle to make it back to the hospital to help.  
> Based on Season 1, Episode 7, “The Hub”

**Notes for the Chapter:**

> We read that initially episode 1x08 "The Well" was supposed to come before episode 1x07 "The Hub" which made a little more sense in terms of the character arcs, and so we decided to parallel that here.

Fitz, Simmons, and Skye were enjoying a moment of quiet in the office. In a few days they would leaving the wards and getting their first electives. Even though Skye was enjoying the wards more than she had thought she would, she could not wait to have a break from the grueling schedule.

“What do you guys go to next?” Skye asked. 

“I’m going to go to oncology clinic,” Simmons said.

“Cool. I’m going to be working at the public health department,” Skye said.

Fitz looked glum. “I have the ICU.”

Simmons patted him on the back reassuringly. “I’m sure it won’t be as bad as everyone says.”

“Yeah, you’ll get to do some cool procedures,” Skye said.

“And work with new people,” Simmons said.

“That’s true. At least I won’t have to keep working with Ward. I don’t think he likes me,” Fitz said.

“I don’t think he can like anyone. He’s a robot,” Skye said.

Simmons giggled. Just then Ward came back into the office. “What’s so funny?”

“Nothing. We were just talking about our next rotation. What are you going to?”

“ICU,” he said. He looked at Fitz. “We’re going to be on call together.”

Fitz looked horrified at the thought of spending a 24 hour shift with Ward. “Great.”

*****

Fitz stared morosely out the window of the ICU watching the clouds gather overhead while Jane Foster oriented them to the ICU. Beside him Ward nudged him.

“Pay attention,” he hissed.

“It’s supposed to start snowing,” Fitz said. They had not had a real winter storm in DC that year, but from what people had told him DC was not as well-equipped to handle snow as Boston had been. In Boston even a heavy snow could not slow down to the city, but he had heard stories about DC grinding to a halt for several days after what the residents dubbed Snowmageddon 2010. 

Ward shrugged and gestured towards Foster.

“Now the first few shifts are going to be a little unusual because the American Thoracic Society’s annual meeting is tomorrow in San Diego. So I’ll be leaving later today as will all of the fellows. Dr. Hand is going to be acting as both the attending and the fellow.”

From the doorway a woman asked, “Who is on call today?”

“Grant Ward and Leo Fitz, Dr. Hand,” Foster said.

Hand looked critically at them. Her grim expression told Fitz that despite the magenta streaks in her hair she was not someone to joke with. “I’ve heard excellent things about both of you from Dr. Coulson. Try not to disappoint me.”

Fitz had never received a compliment that sounded so harsh. He glanced at Ward who had his robot face on.

“Yes ma’am,” Ward said.

*****

The morning was busy but not crazy as they rounded on the patients in the ICU. Fitz took copious notes of each patient’s condition and what to do in emergency situations. Ward had assured him that Fitz would never be completely alone in the ICU, that he could always rely on Ward in an emergency, but they had so many sick patients. If more than one crashed at a time Fitz would have to jump in.

It was not long after Foster ran the list with them one more time and then dashed to the airport for her flight to San Diego that Victoria Hand came over to where Ward and Fitz were working. Fitz was writing a summary of a patient’s stay in the ICU so that they could transfer a patient to a rehab. It was tedious work going through every day of the past month and a half to summarize everything that had happened to her.

“Ward. Fitz,” Hand said.

“Yes ma’am,” Ward said.

“I was called about a few transfers into our ICU from outside hospitals, but with the storm I don’t think that they’re going to happen tonight.”

Ward nodded. “Things tend to get quiet when the weather’s bad.”

“Things in the hospital are quiet now as well. Do you have any questions about the patients in the unit?”

“Does that mean that Marta is not going to make it to the rehab today?” Fitz asked. Ward shot him a dirty look.

Hand raised an eyebrow. “Marta?”

“Marta White. The patient in bed 3.”

“Her. No, there are going to be no transfers out of the unit today.”

Before Fitz could say anything else Ward said, “I don’t have any questions about the patients.”

“Good. I’m going to go home before the storm gets too bad. Call me with any emergencies. Be ready to round at 9 am tomorrow.” She handed the code pager to Ward. “With no fellow in the hospital you’ll be in charge of the code pager, Dr. Ward.”

*****

It was already snowing when Skye and Simmons left the hospital. Skye scowled at the flakes.

“Damn. I have to drive all the way across town in this.”

“It’s not so bad.”

“You forget, I’m from Texas. I’m not used to driving in all of this.” She waved her arm around for emphasis.

“You can come over to my place first if you like,” Simmons said. “We can have some dinner, and then you can go over to your place once the snow stops.”

But two hours later the snow was only falling harder. Skye and Simmons peered out the windows anxiously.

“There’s far too much snow out there for you to drive home safely,” Simmons said. “You should spend the night here. I’ll get some blankets and pillows, and we can make up the couch.”

“I hope Fitz and Grant are okay,” Skye said. “Do you think the snow will make things crazy back at the hospital?”

“Perhaps, or perhaps they’ll have a slow night if people can’t get to the hospital,” Simmons said.

“I wonder how much more snow we’re going to get.”

*****

“ … and then Simmons was finally done getting scrubbed up for her first OR case, and she goes into the OR to have the nurse help her into her sterile gown, and she sneezes all over her.” Ward did not react, so Fitz scowled and said, “It’s funnier when Simmons tells it.”

“Have you got the lumbar puncture kit?”

“Yes,” Fitz said, a bit testily.

“Good. Now hold the patient very still while I do this.” Fitz made a face. “Or you could do it, and I can teach you.”

Fitz shook his head. The thought of shoving a needle into someone’s spine creeped him out. “I’ll just watch this one.”

*****

During a lull Fitz ran down to the cafeteria. Even though it was supposed to be open 24 hours a day he got there right before they were closing down because of the storm. He ordered some onion rings and a grilled cheese sandwich with ham.

Back in the ICU he found Ward hovering outside room 5. “Do you want some?”

Ward eyed the food distatestfully. “Where were you? We’re not allowed to leave the unit except for emergencies. What if the code pager had gone off? I need you here watching the patients.”

“Sorry. Do you want some? I got some coffee too.”

“I only eat protein bars and NOS when I’m on call.” 

Fitz made a face. He did not know people actually drank those horrible energy drinks that the gift shop sold.

“Put the food down. I need you to pay attention. We need to start room 5 on a diltiazem drip, and if that doesn’t work we’ll have to cardiovert him. Room 7’s arterial line needs to be replaced, and room 3 needs a repeat hematocrit. If it’s lower we’ll have to transfuse her and figure out where she’s bleeding from. Room 10 needs a new central line. Which of those do you want to take care of? Have you ever done an arterial line?”

Fitz was scribbling instructions on his sheath of notes. “No, not yet.”

“How have you not done that yet? Nevermind. I can supervise you once we’ve taken care of everything else.”

“Actually, that’s okay. I don’t have to do that one. I’ll take care of Vladimir’s diltiazem drip and monitoring Marta’s hematocrit.”

“You never want to do procedures. I’m supposed to teach you how to do this stuff, not just do it myself.”

“It’s crazy tonight. I’ll learn them another night. We have a lot more nights on call together.”

He hoped that Ward would leave it at that, let them do their own things, but Ward crossed his arms. “What are you doing here?”

“What do you mean, what am I doing here? This is a required rotation. I need it to graduate.”

“But you don’t have to do S.H.I.E.L.D. ICU. You could do it out in a smaller hospital that’s less busy. That’s what most of the lab rats do.”

Fitz got annoyed. “Why are you here?”

“Look, I don’t mean to insult you, but you don’t seem that interested in critical care or cardiology or doing procedures.”

“You know there’s more than one way to be a doctor. I’m a scientist. I have an M.D./Ph.D. from Harvard. I’m going to be a researcher. Discover new cures for cancer. And sure, I may not be a jump in there and save the day kind of future cardiology jock, but that doesn’t mean I don’t have a place in the ICU. I took this rotation so I could learn to take care of sick patients, same as you. Medicine needs doctors like me and doctors like you.”

Ward looked surprised at Fitz’s outburst. “Okay. You’re right. It’s crazy tonight. We should divide and conquer. There’s only a few hours left until rounds. You take care of rooms 3 and 5, and I’ll do the procedures on 7 and 10. But if we need to do another procedure it’ll be faster if we do it together.”

“Fine.” Fitz grabbed his sandwich and took a huge bite.

*****

“I’m starving,” Fitz said as he and Ward frantically finished writing their notes before rounds. Coulson never minded if the interns presented from memory and scribbled notes in the morning, but Ward warned him that Hand would expect formal presentations on every patient. “I wonder what Dr. Hand is going to bring for breakfast.”

“I doubt she’ll bring anything.”

“But everyone brings donuts or bagels at least. When I was in medical school I had an attending on pediatrics who brought us breakfast sandwiches from Dunkin Donuts.”

One of the nurses overheard them and looked pitying. “Haven’t you guys seen the news? Or looked outside?”

“What?” Fitz asked.

The nurse pointed out the window. “We’re snowed in. It’s worse than Snowmageddon.”

Fitz ran to the window. The streets were so full of snow that he could barely see where the cars were supposed to go. Despite it being 8:30 he did not see any tire tracks through the snow from people driving into work. “How am I going to get home?”

As if on cue their pagers went off.

_Team. Not coming into the hospital today. Other residents snowed in. Page me with questions. VHand._

Fitz looked at Ward. “What are we supposed to do?”

“Our jobs. Eventually someone will make it in.” Ward looked at his watch. “Be ready to round in 30 minutes.”

Fitz was not as confident that someone would come relieve them. Without telling Ward he paged Coulson to let him know what was happening.

*****

“You’re not going in?” Coulson asked.

“I live out in the suburbs,” Hand reminded him testily. “It’s impossible for me to get there.”

“My residents are in there. Ward and Fitz are alone in the ICU.”

“I already paged them to tell them that I cannot make it in today. They will call me with any emergencies.”

“What about the other ICU residents?”

“Grey, Summers, Parker, and Drake are all snowed in.”

“What are Ward and Fitz supposed to do? They can’t work there alone indefinitely. It’s not safe.”

“This is an emergency, Coulson. When the city clears the streets we’ll be able to get to the hospital. Until then your residents are going to have to deal with it. We did more when we were residents.”

“That’s not good enough,” Coulson said and hung up the phone.

*****

Coulson sent out an email to all the residents as soon as he got off the phone with Victoria Hand.

_Despite the terrible storm last night, S.H.I.E.L.D. Memorial Hospital remains open for business. If you are on a critical rotation such as the wards or ICU, your colleagues who were working overnight at the hospital need your help. If you live close to the hospital or have access to a vehicle that can make it through the snow, please email me so that I can coordinate rides into the hospital. Stay safe out there._

Within moments of sending the email he was flooded with replies. Hand had been right that the other residents in the ICU lived too far or were too snowed in to make in. Parker lived with his grandmother out in Columbia, Summers and Grey shared an apartment in Bethesda, and Drake lived in a part of Chevy Chase that according to the news had been particularly heavily hit by the storm, with downed power lines making it impossible to drive through.

The other services were not as severely affected. More of those residents lived closer to the hospital. Some of the residents on elective even emailed to help. Logan volunteered to pick up several residents and drive them to the hospital in his huge SUV. Given how close Fitz, Simmons, and Skye were, he was not surprised to read an email from Skye offering to help as well.

_Simmons and I are on elective, but we live pretty close to the hospital. (Well, Simmons does, and I spent the night on her couch.) What can we do to help? Fitz is in the ICU. Is he going to make it home? - Skye_

*****

Skye and Simmons were surprised by how quickly they got a response from Coulson.

“He says that we don’t have to come in, but if we want to help, we can try getting a ride in with Dr. May,” Simmons said.

“We can’t just stay here,” Skye said. “They’re our guys. We have to do something. Even if it’s just bringing them clean clothes, or a sandwich. How do we get in touch with Dr. May?”

“I’ll email her. She actually only lives a block away from here. Sometimes Fitz and I see her out running.”

They stared at the computer screen impatiently. “Do you know which house is hers?” Skye asked.

“It’s on this street on the next block.”

“We should go down there. She might leave before she checks her email.”

The two women threw on their coats, hats, and shoes as quickly as possible and ran down the street through the snow. It was slow going. The sidewalk had not been shoveled, so they had to climb over the snow bank that the plow had formed and run through the street. May looked surprised to see them when she answered the door.

“We need a ride to the hospital,” Skye said. “Coulson said that you’re going in.”

She nodded. “Are you working today?”

“No, but Fitz and Ward are there. They’ve been in the ICU all night. We want to go help them.”

“Have either of you been on the ICU yet?”

“No, but they’re our guys. We want to go help them. The place has got to be crazy right now, and they need some backup.”

She nodded. “Get your things and meet me at my car.” She pointed down the street. Her black SUV was barely visible under the snow. “It’ll take me a while to dig it out.”

When they got inside, they immediately started throwing their keys, phones, and wallets into their bags. “If you go downstairs, there’s some clean laundry on top of the dryer,” Simmons told Skye. “You can get some clean clothes for Fitz.” Skye nodded and grabbed some underwear, socks, and a T-shirt. When she got back upstairs, Simmons was finishing three sandwiches. “Prosciutto, buffalo mozzarella, and pesto aioli,” she said. “It’s Fitz’s favorite. I made one for each of us as well.”

“Great. Come on, we better hurry before May leaves without us.”

*****

Fitz had never been so tired in his entire life. They rounded on the patients quickly, mostly Ward dictating a to do list on every patient to Fitz and the nurses. After rounds there was still a lot to do. Ward had not had the time to replace the central line on the patient in room 10, so he did that first thing while Fitz checked on Marta in room 3. She was getting a transfusion, but they had not figured out where she was losing so much blood from. 

“Marta, what’s wrong? Where are you bleeding from?” he asked her.

Marta shrugged. She spoke limited English. Fitz was not even sure that she knew what he was saying. He tried to gesture whether she had noticed any cuts or bruises, but she only looked confused and slightly sick. She gripped her stomach and suddenly threw up all over the bed. Big chunks of blood came up as well.

Fitz struggled not to vomit as well. “Well. I - ah - guess that answers that question.”

He quickly retreated out of the room to tell Ward while the nurse cleaned up Marta. Before he could find Ward though another nurse pulled him into room 5. Fitz stared in horror at the monitor above Vladimir. His heart rate, which had been hovering around 130, was suddenly much higher, and his blood pressure had dropped.

“What do you want to do doctor?”

“What’s the diltiazem dose?”

“Maxed out. And the amiodarone is already hanging.” 

“Where’s Ward?”

“Still in with the patient in 10. Someone’s getting him. What next doctor?”

The way the nurse said the word “doctor” felt like a challenge, or maybe that is just how it seemed to Fitz’s sleep-deprived brain. He tried to focus. If she were here Jemma would remind him that every challenge on the wards was just an exam question in three dimensions and has a solution.

“Get the defibrillator. We have to shock him.”

The nurse nodded and grabbed the defibrillator from the hallway. Instead of the paddles that he remembered from watching ER and Grey’s Anatomy it had sticky pads to conduct the electricity. Together they put the pads on the patient.

“Charge at 200 joules. Clear.” The nurse raised her hands and nodded at Fitz, and he pressed the cardiovert button. Vladimir’s body jolted as the electricity coursed through it, then lay still. On the monitor his heart rate slowed back down to a safe rate, and his blood pressure came back up.

Ward rushed up behind him. “What happened?”

Fitz pointed at the monitor. “His heart rate sped up, and his blood pressure dropped, so I shocked him.”

“Nice.” Ward looked appreciatively.

“And Marta threw up blood on me. She’s getting a transfusion now. What’s next?”

“She’ll need a central line. Ever done one?” Ward asked.

“No. Let’s do it. I’ll get the equipment.”

*****

The central line was harder than they thought. Marta threw up again halfway through the procedure, and Fitz had to hold perfectly still with a wire sticking in her jugular vein while the nurse suctioned vomit from Marta’s mouth. Fitz handled it all better than Ward thought he would though and got the line in without incident. Now the nurse was hanging another two units of blood while Ward and Fitz called everyone they could think of from GI to get someone to come in and stop the bleeding from her stomach. They were interrupted by a trio of nurses coming to the desk.

“Doctor, Room 5’s blood pressure dropped. And she threw up more blood.”

“Doctor, Room 3’s heart rate is back up to 150, do you want to shock him again?”

“Doctor, Room 10’s blood pressure dropped too, and he’s clutching his chest.”

Ward looked at Fitz. They had both been on duty for nearly 36 hours, running around like crazy the entire time. He was so sleep deprived that it was getting hard to think straight, and the knowledge that they would have to keep going indefinitely made it hard not to just crawl into a corner and give up.

“I can -” Fitz began, and then the code pager went off.

Ward stared at it. Room 636. He stood up and grabbed his stethoscope from the desk. “You’re in charge Fitz.”

Before he could run out though someone grabbed the code pager out of his hand. Ward was surprised to see Logan, one of the third year residents.

“I got it man.”

Ward was so happy that he could have kissed Logan. “What are you doing here?” Ward asked.

“Coulson called us all in to help. I'll take the code pager off your hands so you can focus on shit up here.” Logan hurried out of the ICU.

Fitz pointing towards the main nurses’ station. “Look.”

Ward looked up to see May standing at the nurses’ station talking to the charge nurse with Coulson. He had never been so happy to see someone before in his life. He was so happy that he gave her a huge smile before he could think about what it might mean in the larger, we-just-had-sex-after-a-terrible-day-at-work sense.

She met his eyes and gave him a small smile back. Coulson spotted him and walked over. “We’ve got it from here. You both should get some sleep. You look exhausted.”

“Thanks. I’m glad to see everyone. It was nice of them to come in through the storm.”

Coulson shrugged. “You know what they used to call us when I was in residency?”

“No what?” Fitz asked.

“Osler Marines. We leave no man behind.”

Simmons and Skye came running from behind Coulson. “There you guys are,” Skye said.

“Fitz, we brought you a change of clothes, and your favorite sandwich -”

“Prosciutto, buffalo mozzarella, and pesto aioli?” Fitz asked, excited.

Simmons nodded. “Oh, I only made three… “ she said, looked at Ward.

“Do you want half?” Fitz asked Ward.

Simmons shook her head. “No, no, after last night you both deserve a full sandwich. Skye and I can share.”

Skye punched Ward in the shoulder. “You look beat. Must have had a crazy night last night.”

“It wasn’t so bad. I had a great intern backing me up. Couldn’t have done it without him. He saved a guy’s life single-handedly.”

“Really?” Skye looked impressed, and Simmons looked excited.

Fitz shrugged. “I shocked a guy.”

Coulson looked impressed as well. “Good job both of you. You did great, but your relief is here. There’s enough coverage on the floors, and Dr. May and I can supervise Skye and Jemma up here.” He took the code pager from Ward.

“Unfortunately I don’t know that it’s safe for you to drive home, with the weather or with your present state of exhaustion, but there’s always the call rooms,” Simmons said.

Fitz nodded. “I could sleep for a hundred years right about now.” He followed Ward into the ICU call room and collapsed onto the bottom bunk to eat his sandwich. He was asleep before he even unwrapped it.


	9. Thanksgiving

**Summary for the Chapter:**

> The residents take a break from the wards to enjoy Thanksgiving dinner with May, Coulson, and the rest of the S.H.I.E.L.D. doctors.

**Notes for the Chapter:**

> Initially, we intended to only include canon ships in this story, but the fact is that at our core, we are Coulson/May shippers, and we ended up making a shippy backstory for them. This is just the teaser - it is fleshed out more in _Nicest Thing _.__

Skye, Simmons, and Fitz had been planning to spend Thanksgiving drinking beer and watching TV, but when Coulson invited them to his house for dinner, he would not take no for an answer. Unlike most of the attendings, he lived in the city in a nice condo only a couple of miles from the hospital.

“Come in,” Coulson said. “You can put your coats in the closet.”

“Happy Thanksgiving, sir,” Simmons said, handing him a six-pack of beer.

“Thank you.” He took the beer and gestured towards the living room. “Most people are in there. Help yourselves to food or drink. There’s beer in the fridge, and wine and liquor in the living room.”

Fitz followed him into the kitchen to get a beer. May was checking the turkey while Banner made mashed potatoes.

“Do you need any help?” Coulson asked.

“Not from you,” May told him. “Stop hovering.”

“It smells great.”

“You could chop these onions,” Banner suggested.

May shook her head. “No he can’t. We’d be here all night. Fitz, can you chop them?”

“Sure,” Fitz said.

“He came in to get a beer,” Coulson said. “Don’t put him to work.”

“I don’t mind,” Fitz said. “Now where would I find -” May pointed him to a knife and cutting board, and he started chopping the onions quickly.

Coulson continued to watch them until May rolled her eyes at him and said, “Get out now.” Her tone made it clear that she would not accept any arguing.

“This is a nice place,” Fitz said. “Dr. Coulson has a nice kitchen.”

May rolled her eyes. “He hardly uses it. He can barely boil pasta.”

“He has a lot of cooking stuff,” Fitz observed.

“Most of it’s mine. I brought it over with me,” May explained.

“If he can’t cook, then why is he hosting dinner at his place?”

“We rotate having Thanksgiving at our places,” May said. “Usually whatever girlfriend he has at the time cooks when it’s his turn.”

*****

“So where are Pepper and the kids?” Coulson said.

Stark scowled and took a swig of his beer. “They’re at Pepper’s parents’ house in Connecticut. I’d be there with them if I didn’t have a bunch of meetings tomorrow. This job.” He shook his head.

“It’s tough.”

Changing the subject, Stark waggled his eyebrows at Coulson. “So you and Melinda certainly have gotten close.”

“We’ve been working together a lot this year for the residency program. And we’ve been friends for a long time.”

“I know, but you’ve never been quite this close. I mean, she’s cooking Thanksgiving dinner for you.” Tony gave him a meaningful look.

“I suggested getting take-out, but she shot me down. Trust me, you would not want to have to rely on me to cook a turkey.” He seemed to notice the interns standing awkwardly nearby for the first time. “Have you met Jemma and Skye? This is Tony Stark, chairman of cardiology.”

Simmons smiled excitedly and extended her hand. “Dr. Stark, such an honor. I’m a huge fan. I read your analysis of the OPTIMIZE trial in medical school.”

“Thanks. That’s always nice to hear. Where’d you go to medical school?”

“Harvard.”

“That's where I went. I like this one, Coulson,” he drank the rest of his beer. “I’m going to get another beer. Can I get either of you ladies something to drink?”

Simmons and Skye shook their heads.

While Coulson went over to talk to some of the other attendings, Simmons and Skye joined the other interns. They knew Bobby Drake, Anna Marie, and Kitty Pryde a little, but they had not worked together yet.

“Hey guys. You didn’t have to work today?” Skye asked.

“No. Our resident covered for us. I think it’s tradition,” Drake said.

“Yeah. Ours too. Who’s your resident?” Skye asked.

“Logan.”

Seeing their faces Anna Marie said, “He’s cool. He has his own style, and he’s not afraid to go up against the attendings.”

“It can be pretty funny sometimes. He got into a big fight with Hand once about a patient we sent to the ICU,” Pryde said.

“That sounds like it would be very awkward,” Simmons said.

“That only happened once. Well maybe a couple times. But he gets along with most of the attendings,” Pryde said.

“Which attendings have you had?” Simmons asked.

Drake counted them off on her fingers. “We’ve had Xavier, Lehnsherr, and MacTaggart”

“Do you like them?” Simmons asked.

“Yeah, they’re good. They all have their own style, but you learn a lot of different things. Xavier is amazing. Who have you had?” Pryde said.

“We’ve just had Coulson and May,” Skye said.

“Oh, so you know them pretty well then?” Pryde asked. Before they could answer she leaned forward and said quietly, “Are they, like, married, or a couple, or something?”

“No.” Skye looked for confirmation at Simmons, who shook her head. “Not that we know of.”

“Okay. There was just something weird when we got here,” Pryde explained. “We were the first one’s here, and it was just the two of them arguing in the kitchen. She was cooking and trying to get him to help, but he kept messing up. She finally banned him from the kitchen.”

“But they said it was his house,” Drake interrupted. “There was just a weird vibe. He kept talking about how long they’ve known each other and what a good cook she is.”

“Is he married?” Anna Marie asked. “This place and that sports car he drives scream bachelor.”

Skye realized how little she knew about Coulson or May despite having worked with them for several months. “I don’t know.”

Before they could speculate further May came out into the living room. “Dinner’s ready.”

*****

Coulson was right: May was a very good cook. The dinner was delicious, and the interns focused on enjoying their first home cooked meal in months, letting the attendings and fellows fill up the room with conversation. Mostly it was about Thanksgivings gone by or inside jokes at S.H.I.E.L.D.

Skye was seated across from Banner and Rogers, and during a lull in conversation she asked, “So how long have you guys been doing Thanksgiving together?”

“I’ve been coming for a few years, but I think other people have been getting together before that,” Banner said.

“Coulson invited me my first year of fellowship,” Rogers said.

“So Coulson organized it?” Skye asked.

Coulson overheard her. “Actually this grew out of a tradition we had during my residency. Our program director invited the residents to his house every year for Thanksgiving. Melinda, Clint, and I used to go. When I came to S.H.I.E.L.D. I decided to continue the tradition.”

On the other side of Skye, Drake seemed to be studying Rogers. “You look familiar,” he said.

“I’m a GI fellow. You’ve probably seen me around or gotten a consult from me.”

“No, besides that. Did you play football in college?”

Rogers nodded. “At Cornell.”

Coulson’s face lit up, and Romanov snickered. “Are you a Cornell fan too?” Coulson asked Drake.

“No. My dad went to Penn. I remember seeing Rogers play against them a few times,” Drake said.

Romanov explained, “Coulson went to Cornell. He’s a huge sports fan. I thought he was going to swoon when he found out that a Cornell football player was at S.H.I.E.L.D.”

Rogers looked embarrassed. “It was a long time ago.”

Coulson looked very excited as he said, “I saw you play in the game against Penn your junior year. You were amazing. That touchdown at the end of the second quarter - I’d never seen anything like it.”

May rolled her eyes. “You sound like my brothers.”

“Did they go to Cornell too?” Rogers asked.

“No, her entire family went to Ohio State,” Coulson said.

“Whenever they get together, all they want to talk about is college football.” She looked around the table. “If everyone’s done I’ll bring out pie. Give me a hand, Phil.”

There were several pies to choose from: pumpkin, apple, and chocolate. May started dishing out pie, but when she got to Coulson she frowned. “You shouldn’t eat any pie. It’s full of butter.”

“I like pie.”

“You had a heart attack. Why do I have to keep reminding you of that?”

“I know that I had a heart attack. I take my medications, and I work out. I just want one piece of pie on Thanksgiving.”

Barton rolled his eyes. “Are you sure you two haven’t started dating? You act like you’re married.”

“We are not a couple,” Coulson said stiffly, “and we never have been.”

“Come on, it’s me. I’ve known you guys since residency. I remember how you guys moved in together after your wife kicked you out.”

The room fell silent. Fitz stared intently at his pie while Jemma nervously played with her napkin. Skye just stared back and forth and Coulson and May, mouth open.

Coulson glared at Barton. None of the interns had ever seen him look so angry. “My divorce had nothing to do with Melinda. Now drop it.”

Slowly people resumed eating and making idle chatter. Skye snuck a look around the table. May had relented and given Coulson a slice of pie, which he was eating intently. May was also eating her pie. They were both carefully avoiding looking at each other. Barton looked embarrassed as he drank his beer, and Romanov kept glaring at him.

After dinner, the interns volunteered to help Coulson clean up and retreated into the kitchen. “There’s a lot here,” Skye said. “Maybe we can bring some to Ward.”

“Good idea.” He brought out some extra plastic containers. “Be sure to bring him some pie.”

*****

They found Ward in the office. “Happy Thanksgiving,” Skye said. “We brought you some leftovers from Coulson’s party.”

“So how was it?” he asked as he dug into the mashed potatoes.

The interns exchanged a look. “It was fun,” Skye said. “Kind of weird. We got to hang out with some of the other interns. And there were a lot of attendings there - Dr. May, Dr. Stark, Dr. Banner…”

“Dr. Barton,” Simmons said. “I’m afraid he got rather drunk.”

“He said some weird stuff,” Skye continued. “He asked if Coulson and May are a couple, and then he implied that May broke up Coulson’s marriage when they were residents.”

Ward coughed. “What?”

“I kind of thought you could tell us more,” Skye said.

Ward shook his head. “I didn’t know he was married.”

“Well actually, he’s divorced now,” Fitz said.

Skye rolled her eyes at Fitz. “So do you think Coulson and May are a couple?” Skye asked Ward.

Ward looked uncomfortable. “I don’t know.”

*****

Barton and Romanov were the last to leave. Once everyone else was gone, they went into the kitchen where Coulson and May were cleaning up. Romanov gave Barton a nudge, and he cleared his throat awkwardly.

“Sorry about earlier,” he said.

“You shouldn’t spread that old gossip around,” Coulson said. “It was a long time ago, and it wasn’t true.”

Barton looked like he was struggling with what to say. “It wasn’t just gossip,” he finally said. “Jenny told me.”

“What?” Coulson put the dish he was washing back in the sink. “When?”

“Thanksgiving, the year you were chief resident. She had a little too much to drink, and you were talking to May most of the night, and she came over to me and told me that she thought something was going on between you.”

“There was nothing going on. We were colleagues. Friends.” He sighed. “I need a drink. I can’t believe she told you that.”

“So your wife did leave you because of me.” May’s voice was shaking with anger. “All of these years you’ve been telling people that I had nothing to do with your divorce, and that was a lie.”

“She left me for a lot of reasons. She didn’t like that I was always at work, and she wanted to have children and move back to Boston to be close to her family -” She glared at him, and he trailed off. “And, yes, she was jealous that we spent so much time together. I told her that there was nothing going on between us.”

“You didn’t think you should tell me about this?”

“Tell you what? We didn’t do anything.”

“After the divorce you moved in with me. Did you even think about how suspicious that would look?”

“I didn’t have anywhere else to go. I was at the hospital over a hundred hours a week, I didn’t have time to find a new apartment. You said it wasn’t a problem. We barely even saw each other at home anyway. We were always at work.”

Melinda put down the paper towel she had been using the wipe the counters and grabbed her bag from kitchen table.

“Melinda, wait.” Coulson chased after her. “I’m sorry.”

But she ignored him. A few seconds later they heard the door slam. Romanov punched Barton in the arm. “Nice going.”

Coulson came back in and sighed.

“Do you need help cleaning up?” Romanov asked.

“No. You should just go.”

“Sorry,” Barton said meekly.


	10. Holding On

**Summary for the Chapter:**

> The team treats a woman with stage IV pancreatic cancer whose fiance refuses to accept her grim prognosis.
> 
> Based on Season 1, Episode 9, “Repairs”

When Ward got out of the shower he found May reading his pager.

“It went off,” she said as she handed it to him so that she could finish getting dressed.

The message was from Skye. _When are we starting rounds this morning? Skye._

Ward looked at May. He did not know if this was incredibly funny or incredibly awkward. “What time do you want to start rounds this morning?”

May shrugged. “Around 10. Page me when you’re ready.”

*****

When Skye came into the office after her night on call she was surprised to find Fitz and Simmons sitting in front of the computers flipping through the online faculty directory.

“What are you guys doing?”

“Our elective time is coming up soon -” Fitz said.

“- and we’re trying to find someone to do research with,” Simmons said. “What are you going to do for elective?”

In truth Skye had not been planning on doing anything. She wondered if Coulson would mind if she just slept and tried to catch up on her reading. In her bedroom she had a pile of journal articles to read that Ward had been giving the team since the first day of intern year. “I don’t know.”

“Well you still have time to find someone,” Simmons said.

“We set up some meetings for today and tomorrow to talk with potential labs. Can you cover our pagers for a bit?” Fitz asked.

“Sure.”

“I wish we knew more oncologists,” Fitz told Simmons. “I can’t tell from this website how successful these labs are.”

“Plus it’s hard to know whether we’d get on in the lab. Remember Dr. Raj’s lab at Dana Farber? Brilliant researcher, but she had that one grad student -” Simmons said.

“The one who wouldn't stop singing Lady Gaga songs when she was running PCR? She was terrible.”

“You want to do oncology research? Why don’t you work with May? She’s an oncologist,” Skye said.

Fitz and Simmons exchanged a look. “We don’t want to work with May,” Fitz said bluntly.

“Why not? I mean she’s tough, but she’d probably be okay to work with.”

“Well she has a certain reputation in the lab. Brilliant, but a little intense,” Simmons said.

“Terrifying,” Fitz said.

“Have you not heard about what happened to her clinical trial a few years ago?”

Skye shook her head. Fitz and Simmons exchanged a look. “What?” Skye asked.

“Well, she used to run a lot of clinical trials back in the day -” Fitz began.

“She designed a protocol to treat pancreatic cancer when she was still a fellow at MD Anderson that was the standard of care for a decade,” Simmons interrupted.

“But then she was running a trial a few years ago, and all her subjects started dropping like flies.”

Skye looked horrified. “Why?”

Simmons shrugged. “Nobody knows. Sometimes that happens. The chemo regimen must have been a bit too strong.”

“But when she saw those results she went a little crazy. She messed with the trial somehow, and she had to go before the S.H.I.E.L.D. research ethics committee to defend her actions. The trial ended early, and after that she was banned from clinical research and clinical practice.”

“Wow. So why did Coulson let her back onto the wards?” Skye asked.

Fitz and Simmons shrugged. “Being a ward attending isn’t very popular around here. Maybe he was desperate,” Fitz said.

Ward came into the office. “How was your call?” he asked Skye.

“Pretty good. I got a really interesting patient, Hannah Hutchins. She’s was in a pancreatic cancer vaccine trial but came here for this super crazy surgery.”

“You mean a Whipple?” Ward asked.

“It’s like a modified Whipple that’s even more aggressive.”

Fitz made a face. “That sounds drastic.”

“I thought that vaccine trial looked quite promising,” Simmons said.

“Her fiance said that she was in it for a while, but it stopped working, so they came here for another option.”

“If she’s here for surgery then why is she on our service?” Ward asked.

“She hasn’t met with the surgeons yet,” Skye clarified. “She has an appointment tomorrow afternoon, but while she was waiting she got really nauseated and had to come to the hospital. I already consulted surgery.”

Ward frowned. “May doesn’t wants you to call consults without running them by her first. Especially for an oncology patient.”

Skye rolled her eyes. “What’s she going to do? Refuse the patient’s wishes?”

“No, but we shouldn’t substitute their judgement for our own. Just because they want surgery doesn’t mean it’s the right answer.”

On rounds May raised her eyebrows but did not comment when Skye mentioned already calling surgery. They had asked her to get an MRI of her abdomen in addition to the CT scan that she already had gotten in the ER.

As Skye slowly scrolled through the images, May frowned. “Can I see that?” she asked. Skye handed her the mouse, and May looked carefully at the scans. Finally she said, “This woman has already had a Whipple.”

“What?” Ward asked. He peered over May’s shoulder.

“When you present a patient you need to include all information related to past treatments, medical as well as surgical,” May said.

Skye tried to swallow the feeling of embarrassment. She never felt that way when she made a mistake in front of Coulson. Coulson had a way of making you want to do your best without feeling like a failure if you messed up. Even though May was always quiet and seemed detached from the team, she always looked disapproving. When she was on service, Skye felt like the team was constantly waiting for her to start yelling at them for being stupid. 

Skye had spent over an hour with Ms. Hutchins and her fiance going over her history. She crossed her arms defensively and said, “She and her fiance didn’t mention any previous surgeries.”

“Did she have any scars?” May asked.

“I don’t remember,” Skye admitted.

May nodded. “We need to talk to them. Find out what they’re doing here.”

“They want another opinion. Her fiance read an article about a modified Whipple procedure that the surgeons here are doing.”

May shook her head. “There’s nothing they can do.” She gestured at the screen. “The cancer is too advanced, and someone already took out as much as they safely could.”

Skye bristled. “What’s the harm in just asking the surgeons?”

May stared at Skye. “What is it the patient is looking for?”

Skye looked confused. “What do you mean?”

“Why does she want the surgery?”

“She wants them to cure her of the cancer that’s killing her. Why else?”

“So she doesn’t know that this is terminal,” May said flatly.

“Wait, what?”

“This stage of pancreatic cancer. It’s terminal.”

“So you’re just going to walk in and tell her that she’s going to die no matter what?”

“It’s the truth.”

*****

When May finished explaining the grim situation to Hannah Hutchins and her fiance Tobias Ford, Tobias started pacing around the room angrily.

“You’re not a surgeon. Who are you to give us this kind of news? We want to talk to the surgeons.” He clenched his fists, and for a moment Skye was afraid that he was going to hit May. Ward seemed to think the same thing because he shifted so that he was positioned between May and Tobias.

May however stepped away from Ward so that she was facing Tobias and Hannah directly. “I specialize in pancreatic cancer. Based on my experience I know that no further treatment will be beneficial. This can’t be the first time you’ve heard this.”

Hannah seemed oddly calm compared to her fiance. “They said something similar at the other hospitals we went to.”

“Those doctors didn’t know anything. They just wrote her off,” Tobias said. “They acted like they knew everything, but they weren’t God. Only God knows that.” 

Hannah looked at Tobias sadly. “But all the doctors have said that there aren’t any other options.”

He grasped Hannah’s hand tightly. “So we’ll find new doctors. Better doctors. We just have to have faith. Miracles happen every day.”

“They do, but Ms. Hutchins is beyond that now,” May said.

Tobias looked angry. “We’re not going to stay here and listen to this. I’m getting my fiance out of here.”

“She’s too sick to leave right now,” Ward said. “She’s severely dehydrated. Once we stabilize her you can take her wherever you want.”

Tobias looked like he wanted to protest further, but Hannah touched his arm. “Please Tobias. I just want to rest right now. I’m so tired.”

He glared at the doctors. “Get out. You’re upsetting her.”

*****

Skye did not feel like listening to Dr. Barton talk about his HIV/AIDS research in Africa during noon conference, so she took her plate of overcooked lasagna back to the office to read up on pancreatic cancer. Whatever May might say, it did not seem right to give up on Hannah. She had come to S.H.I.E.L.D. for a miracle. Coulson always said that that was what they were there for: to connect cutting edge research with real people. 

“Catching up on your reading?” Ward asked when he came back into the office.

“Trying to find a treatment for Hannah.”

“Well I applaud the effort, but I think your time is probably better spent somewhere else. She’s terminal.”

Skye shook her head. “Coulson wouldn’t give up. I don’t understand how May can. It’s like she sees Hannah as a statistic instead of a real person.”

“May is a research scientist. She’s an expert in pancreatic cancer.”

“She’s an expert at dealing with cell cultures and lab rats. But she doesn’t know how to deal with people. No wonder she got banned from the wards.”

“Banned from the wards? Where’d you hear that?”

“Fitz and Simmons told me about her clinical trial that went south. Got her banned from the wards.”

Ward snorted. “She didn’t get banned. May got a large grant from the NCI to fund her laboratory research, and she chose to take herself out of the wards to devote more time to that.”

“But what about the clinical trial? I heard that all the patients in her study died.”

“It’s pancreatic cancer research. Her treatment regimen did a little bit worse than standard therapy, that’s all.”

“Oh.” Skye wondered how everyone could think that having all of your patients die was not a big deal.

*****

“Just because she’s a good lab rat doesn’t mean she knows anything about taking care of people. She’s so cold,” Skye complained to Coulson in his office. She could not shake the bad feeling she had about the case. May might be the attending, but Coulson had told them that they could always come to him with questions or problems, and no one else was willing to listen to her.

She was surprised when Coulson looked sad and shook his head. “Don’t say that.”

“What?”

“I’ve known Melinda a long time. We were residents together. Back then she was different. She always expected a lot from herself and those around her, but she was warm and caring. Her patients loved her. She used to spend hours with them - listening to their problems, comforting them when they were upset, bringing them things to cheer them up. Sound familiar?”

“So what happened?” Skye asked.

“She had a clinical trial that turned out badly. High mortality in the treatment arm. She stopped the trial early and did everything she could think of to save them. But it wasn’t enough. After that she said that she shouldn’t be caring for patients until she better understood what was wrong with them.”

“So that’s why she left clinical medicine.”

“She may seem cold and detached, but she cares about all of her patients. She just knows how to keep that from affecting her judgement.”

“But what am I supposed to do about my patient? She and her fiance are furious at Dr. May. They’re going to leave AMA.”

“Talk to them. With Melinda.” When he saw the skeptical look on her face he added, “If you run into problems, I’m always here to help.”

*****

Hannah was alone in her hospital room when Skye came by to check on her after talking with Coulson.

“Hey. How are you feeling?” Skye asked.

“A little better. The fluids helped.”

“Were you able to eat anything?” Skye asked.

Hannah shook her head. “A few ice chips, but not much else. I’m still so nauseated.”

“Take it easy, and don’t be afraid to ask for anti-nausea medicine. You have a partial bowel obstruction, but it looks like it’s slowly resolving.”

Hannah nodded. “I’ve been through this all so many times.” She started to cry quietly.

Skye sat in a chair next to her bed. “That must be really hard.”

Hannah nodded. “I think it’s even harder on Tobias.”

“Where is he?”

“Back at the hotel, getting our things. He wants to be able to leave as soon as possible.”

“Where are you going to go?”

“I don’t know. He mentioned trying Mayo or Dana Farber next.”

“I’m sorry we couldn’t offer you something here.” May had canceled the surgery consult after rounds, and Skye felt guilty for being too afraid of May to call them to come by anyway. She wondered if she should page someone now. Even if May yelled at her, it would be a small price to pay if they could offer treatment to Hannah. “Those are good hospitals.They might have something you haven’t heard about yet.” She had thought that her words would make Hannah feel better, but she only cried more.

“I’m so tired,” she whispered.

“Hannah, what’s wrong?”

Hannah twisted the bedsheets under her hands. She shook her head slowly. “I don’t want to let down Tobias, but I don’t know if I can keeping doing this.” Tears were trickling down her face.

“How could you let him down?”

“He wants me to be strong. To fight this off, so we can get married and start our life together.”

“What do you want?”

“I want to get better too, but I don’t think that can happen. I just want to see my family again. I want to spend the time I have left with Tobias and my family.”

“Where is your family?”

“They’re in Utah. I haven’t seen them in months since Tobias drove me out here to get a second opinion.”

“I’ll talk to the team. There has to be something we can do to get you back there.”

“How am I going to tell Tobias?”

Skye squeezed her hand. “We’ll tell him together.”

*****

May was in her office when she got a page from Hannah Hutchins’ nurse that her fiance was back and threatening to sue the hospital. Most of the time patients and family members were only bluffing when they threatened lawsuits, but after their first meeting she suspected that Tobias Ford was one of the few who might actually try to take them to court. Rather than making the residents wade into the situation by themselves, she decided to handle it herself. When she got to the room Tobias was throwing Hannah’s things into a suitcase while Hannah cried in her bed.

“These doctors are quacks, Hannah. They may claim to be the best, but I’ve never see doctors who give up so quickly. We’ll drive up to Boston - Dana Farber’s a great place, and I’ve been reading about some of their pancreatic specialists. And if that doesn’t work we’ll head west to Cleveland Clinic and Mayo.”

“Mr. Ford. Please stop packing,” May said. By her tone it was clear that despite the word please it was not a request.

Tobias glared at her. “She’s my fiance. I’m getting her the hell away from you people. She doesn’t need this kind of negativity surrounding her.”

“She’s too sick to leave right now. She can’t eat or drink by mouth yet.”

“It’s only an eight hour drive to Boston. She’ll be fine until we get there.”

May shook her head. “I can’t let you take her. This is Ms. Hutchins’ decision.”

“Hannah wants to get out of here. Don’t you Hannah?” He looked at Hannah and seemed to register for the first time that she was crying. “What’s wrong? Are you in pain? Do you need more pain or nausea medicine?”

Hannah shook her head but did not say anything.

Tobias grabbed her hand. “Hannah, baby, what is it?”

Hannah looked from Tobias to May. Then she shook her head sadly. “I’m sorry Tobias. I can’t keep doing this. I want to go home and spend whatever time I have left with you and my family.”

Tobias shook his head. “Baby, don’t give up. We have to have faith.”

May interrupted him, “It’s not giving up. Doctors do everything we can to put off death, but in the end it catches up with all of us. At this point, more surgery or chemo won’t cure her or give her more time. It will only cause her to suffer. All we can do is to help her make the most of the time she has left.”

“How much time do you think I have?” Hannah asked May.

“It’s hard to say for certain. A few weeks.”

Hannah nodded. “I’d really like to go home to Utah and see my family again, but it’s probably too late for that.”

“Not necessarily. We can help you arrange that if that’s what’s important to you,” May said.

“It is.” Hannah looked tearfully up at Tobias. “Tobias, please, say something.”

He had been silent while she and May talked. He cleared his throat, and when he spoke he sounded like he was choking back tears. “I don’t want you to suffer.”

“I know.” She looked up at May. “When could I go back to Utah?”

“A few days. You’ll be stable to fly back once you’re able to eat and drink again.”

The door opened, and Skye, Ward, and Coulson rushed in. They looked surprised to see May already there. Skye looked warily at Tobias, who was sitting beside Hannah holding her and crying.

“We’ll give you some privacy,” May said. She gestured for the others to follow her. 

Out in the hall Ward said, “We heard that Mr. Ford was trying to check Ms. Hutchins out against medical advice. What happened?”

“I talked to them. They’ve agreed to stay until she is tolerating food by mouth, and then they are going to fly back to Utah to be with her family.”

Skye wanted to ask for more details, but she was afraid to. Coulson, on the other hand, touched May lightly on the shoulder and asked, “Melinda, what did you say to them?”

When she looked at him, her eyes were filled with sadness. “The same thing you told me after my clinical trial.”

*****

Skye stopped by Coulson’s office one more time before she went home for the day. The door was open, but it was empty. She had noticed before that it was filed with textbooks and a few collectibles, and she took the opportunity to examine some of them. On his desk he had a model of a heart and framed photo of a residency class, with a young Coulson standing in the middle. Open on the desk was a heavy leather bound book, and Skye flipped to the inside cover to read the title. She was surprised to find the inside cover full of inscriptions.

“Please be careful with that,” Coulson said behind her.

“Sorry.” Skye set the book down. “The Principles and Practice of Medicine? Brushing up for rounds?”

“It’s by William Osler. He founded the first residency program in the country at Johns Hopkins.”

“That’s where you went.”

He nodded. “And Melinda. We were chief residents together. That book was a gift from my residents.”

“Cool. Looks like they wrote some nice things about you in it. I like this one: ‘To cure sometimes, to ameliorate often, to comfort always.’ ”

“So do I. Do you know who said it?”

“Osler?”

“Good guess, but no. Actually it was Hippocrates. Even back then they knew that we can’t cure everyone.”

“Especially back then.”

“But it’s still true now. We may know a lot more now, but we still can’t stop death.”

Skye nodded. “I wish we could have done something for Hannah.”

“I know that it feels unsatisfying, but you’ve given your patient a lot. She’s going to spend her last days feeling comfortable with her family instead of being miserable in the hospital.”

“I don’t know how anyone can do oncology. It’s so depressing.”

Coulson smiled. “I remember Melinda saying something similar when she was an intern, but she wound up liking it.”

“You said that she was used to be different.”

Coulson nodded. “Actually when I read your application you reminded me of her a little.”

Skye was shocked. “Really?”

He pulled the file out of his desk. “You didn’t think I picked you because of your grades or board scores, did you? Because they were fine but nothing special. Here it is.” He pulled out her personal statement. “You wrote the typical things about wanting to be a doctor because your father is a surgeon, and you like fixing things, but then there was this part here at the bottom about how you had a patient in medical school who had to be in the hospital for her daughter’s graduation. She was a single mother, and so on your day off you went to the graduation with your computer and video chatted with her so she could see it.”

“My father said it was stupid. He said I should have studied for my internal medicine exam instead. I didn’t do very well on that one.”

“Facts can be taught. Compassion can’t.”


	11. Limits

**Summary for the Chapter:**

> The team cares for Mike Peterson, who has suffered complications during his treatment for tuberculosis, but his return puts Dr. Coulson in jeopardy.
> 
> Based on Season 1, Episode 10, "The Bridge"

The speaker for medical grand rounds that week might be a genius in the study of hypogonadism, but his monotonous tone made it hard to stay awake as he droned on. Even Coulson, who was sitting in the front row between Fury and Hill, looked like he was having trouble concentrating. His head was bowed forward like he was sleeping. The beep of a pager echoed through the hall, and Ward noticed May glance at her pager before getting up and leaving. He smiled to himself and waited a minute before joining her.

Just outside the lecture hall there was a table set up with coffee, and he poured himself another cup while waiting for May to get off the phone.

“What was his temperature?” Pause. “He needs to be admitted for IV antibiotics. I’ll make the arrangements.” Pause. “I won’t be his doctor while he’s in the hospital, but I will speak to the team.” Pause. “I’ll see you when you get here.”

Before she went back into the lecture hall, Ward stopped her. “Dr. May.”

“Grant.”

“Enjoying the talk on hypogonadism?”

“It’s always good to have a refresher. It’s something that’s often underdiagnosed, especially in oncology patients, because doctors are too uncomfortable talking about sex.”

Ward smiled flirtatiously. “Well I think I’ve shown that I don’t have that problem - more than once.”

“Not here,” May said tightly.

Behind them, someone cleared his throat. They turned to see that the lecture had ended, and doctors were streaming out of the lecture hall. Coulson was standing right behind them. “We’re rounding.” His face was completely neutral, and May could not tell how much Coulson had overheard. She gave Ward a look as he hurried off after Coulson.

*****

They had just finished rounding on the last of the new patients when Coulson’s pager went off.

“Hmm. That’s odd,” he said glancing at the message. “It’s the ER. They say that one of our patients is downstairs.”

“Who?” Skye asked.

“Do you remember Mr. Peterson from a few months ago?”

“Of course I do. He was the first patient I admitted.”

“You always remember your first,” Coulson said. His tone was so serious that Skye wondered if he recognized his own joke.

“What’s wrong with him?” Simmons asked.

“I don’t know. They want me to check him out in the ER.” He looked at the team. “I know that Medicine 516 is handling admissions today, but we should admit him if he needs to come in. We already know him well.”

Ward nodded. “Skye can take him since she had him before.”

“Sure, no problem,” Skye said. During his last admission he had stayed on their service for two weeks until he was no longer contagious. Over that time Skye had bonded with him - bringing him magazines and books, and playing board games with him on slow call nights.

In the ER they found him tucked away in a room in the corner.

“Mr. Peterson, how are you feeling?” Coulson asked.

He smiled when he saw the team. “Not so good, Doc, but I’m glad to see you guys. You took such good care of me last time.”

“What’s been going on since we discharged you?” Coulson asked.

“At first everything was going well. I felt good, and I was staying with my sister and looking for work. But then my eyes turned yellow, and I got really sick to my stomach. I couldn’t keep anything down, and I passed out at home. The ambulance took me to Centipede Hospital. They said I was in liver failure because of the antibiotics.”

“Oh no! But you have to be on those antibiotics for six to nine months,” Simmons said.

“Once my liver got better they started me on another bunch of antibiotics. Since I don’t have insurance, they signed me up for a clinical trial looking at new regimens, so I didn’t have to pay for it. I felt better for a while, but then a few weeks ago my cough came back. The doctors at Centipede said I was fine, but when I coughed up blood last night, I knew I should come back to S.H.I.E.L.D.” He looked at Skye and Coulson as he said, “Last time I was here you did so much for me. I knew I could trust you to take care of me again.”

Simmons and Fitz nodded vigorously, and Skye smiled reassuringly. “We’ll get to the bottom of it. You can count on us.” When she glance at Coulson though she noticed that he looked grim.

“Mr. Peterson, I’m glad you came in. We’ll get you admitted upstairs and start you on some new antibiotics. Do you know which ones they had you on?”

Peterson shook his head. “No. They wouldn’t tell me because of the study. Why?”

“We’ll get another chest x-ray and a sputum culture, but I suspect that this is all your tuberculosis. It may have become resistant to antibiotics, so we’ll need to find a regimen that will work for you.”

“Thank you so much. I knew that something was wrong, but the doctors at Centipede told me that it was all in my head.”

Coulson smiled tightly. “We’ll see you when you get onto the floor, and the infectious disease team will come by to see you as well.” He gestured for the team to follow him out of the room.

In the hallway Skye asked, “Do you really think he got drug-resistant TB?”

Coulson nodded. “Make sure he has an airborne isolation room. Order a sputum culture and call ID.”

Skye nodded. “What antibiotics should I start him on?”

“Hold off on antibiotics for now,” Ward said.

“What?”

Coulson explained, “We can’t treat him until we know what’s going to be effective. ID may have different recommendations, but we need culture data to guide us. Otherwise we risk giving him ineffective medications and causing more resistance.”

“I’ll try to get the records from the study he was in,” Skye said.

“Good idea. I’m not sure how forthcoming they’ll be, but we should definitely try,” Coulson said.

*****

Skye paged ID consults right after talking to Coulson. On the phone Romanoff sounded annoyed at how little they knew about the case. Skye promised to get records from the trial, but several hours later she still had not found a single person at Centipede willing to reveal that information.

“Look, this is for my patient. He’s sick, and without this information he could die,” Skye said.

The man on the other end did not sound impressed. “I am not authorized to release this information to anyone. It is part of an ongoing trial.”

Skye hung up the phone angrily. She picked up her pager and almost hurled it in frustration at the wall but stopped herself just in time.

“Go ahead and throw it. I think they make them extra strong to withstand resident rage.” Skye turned to see Romanoff and Barton standing in the doorway. Barton looked amused. “Or,” he continued, “you could just slam the phone receiver against the cradle. That’s what I used to do.”

Skye did not know how to respond. Barton might be an attending, but he certainly did not act like the other attendings. She wondered how he could be such close friends with May and Coulson. Coulson was nice, but he was always very formal with the residents, and May was so grim all the time. Skye could not imagine her ever relaxing or joking around.

“Were you able to get the records from Peterson’s clinical trial?” Romanoff asked.

“No. I’ve been calling everyone I can think of, but they all say that they can’t release that information because the trial is still going on. It’s like trying to get information out of the CIA.”

Romanoff frowned. “We saw Mr. Peterson and looked through his chart. He probably has multidrug-resistant tuberculosis, but it’ll be hard to come up with an antibiotic regimen without knowing the sensitivities.”

“We got a sputum culture today,” Skye said.

“That could take weeks to grow in a lab. TB grows a lot slower than other bacteria,” Romanoff said. “To be safe let’s start him on these five antibiotics. It should cover him, and if it turns out he’s not as resistant as we think, we can peel some back.” She handed the list to Skye.

“We told him he was going to be here for a while. He didn’t sound too happy about it. Kept talking about his son,” Barton said.

“Yeah, he has a little boy named Ace who’s staying with his sister right now. I’ll go talk to him,” Skye said. “Let him know how important it is that he stay.”

“Not just for him, but for all of us. If he has multidrug-resistant tuberculosis, we can’t let that spread around the city. Peterson is healthy enough that we can treat him, but if someone immunosuppressed from AIDS or cancer got it, it would be much more virulent,” Romanoff said.

Skye was relieved that when she talked with Peterson. Although he was upset about being in the hospital for so long, he understood why he had to.

“The last thing I want is to get someone else sick, especially my son,” he said. “I hate being stuck in the hospital, but I’m not going to leave until you say I’m ready. I don’t want to have more problems.”

“It won’t be that bad,” Skye said. “You can walk around a little so long as you wear one of these masks.” She touched the green mask secured to her face. “And I’ll come by to play board games like last time.” She wondered if she could get the others to come as well. Simmons probably would, but she was not sure she could get Fitz to. He was not as squeamish as he used to be, but he was still a little uncomfortable sometimes with the messier parts of medicine. Plus, the green masks did not fit Fitz’s face securely enough because of the shape of his jaw, so he had to wear a white space-suit looking thing to protect him whenever he went into an airborne isolation room.

“Thanks. I appreciate it.”

“I could see if we could get your a mask for your son too so he can come visit. There must be kid-sized masks somewhere.”

“That’s okay. I don’t want him to come here. It’s too big a risk for him. We can just talk on the phone.”

It seemed very sad to Skye that his son might not see him for several weeks. “Does your sister have a computer? Maybe we could video chat. I’ll bring in my laptop one day.”

Peterson’s face lit up. “That would be amazing. Thank you doctor. You’ve done so much for me. You and all the doctors here.”

Skye smiled. “Just doing our job.”

*****

Peterson had only been at S.H.I.E.L.D. for a few days when Dr. Flowers from Centipede requested him to be transferred to their hospital.

“He’s part of our study,” Dr. Flowers explained to Skye over the phone. “One of the requirements is that he does receive outside antibiotics. We don’t want that to cloud our results.”

“Well your study didn’t work because he still has tuberculosis,” Skye said. “He wants us to treat him now.”

“Did he say that he wants to leave the study?” The words were innocent enough, but there was something almost mocking about the way she said them.

“Yes. Well no, not in those exact words, but the meaning was there.”

“Why don’t you go talk to him? Then talk to your attending and have him give me a call to arrange transport.”

Skye should not have been surprised when Peterson quickly agreed to be transferred to Centipede.

“But why? You were just telling us how they didn’t listen to you, how you got such better care here.”

Peterson looked guilty. “Look, Skye, I really do appreciate everything you’ve done for me, but I have to transferred back to Centipede.”

“I don’t understand. Why?”

He looked embarrassed as he said, “I don’t have health insurance, remember? As part of the trial Centipede is covering all my medical expenses so long as it’s done there. Dr. Barton and Dr. Romanoff said that I could be in the hospital for a month. How much would that cost me at S.H.I.E.L.D.?”

“Honestly, I don’t know,” Skye admitted.

“Well I know that it’s more than I can afford. Dr. Flowers said that if I request a transfer because of the study, you can’t refuse it.”

Skye guessed that Flowers had spoken to him recently, perhaps even before she had spoken to her. “Let me talk to Dr. Coulson first.”

Coulson looked sad when Skye told him what had happened. He sighed. “Unfortunately Dr. Flowers is correct. We’ll transfer him back to Centipede in the morning.”

“But there has to be something we can do,” Skye said.

“We can’t discount the financial blow a stay in this hospital would be for him. Just the bed would cost $3,000 per day, and he may need to be hospitalized for a month.”

“This system sucks. He’s not going to get the best treatment because of money.”

Coulson looked sympathetic. “Write your congressman.”

*****

Coulson barely noticed when he started coughing. Because of all the immunosuppressants he had to take for his transplant, he was constantly getting colds. He just kept himself dosed on over-the-counter cold remedies and hoped it would go away soon. But weeks went by, and every day he seemed to be getting worse.

“This is more than just a cold.”

Coulson looked up at saw May standing in his office with her arms crossed. He tried to look unconcerned as he said, “I’m fine.”

She gave him the same stare she usually reserved for residents and graduate students. “You look terrible. You need to get checked out immediately.”

He sighed. He knew she was right. He could not keep hoping that he would wake up one day and feel better. “I’ll call for an appointment once I’m off service.”

“No. You’ll see him tomorrow. Tony will see you without an appointment.”

“Tomorrow’s my last day on service before Victoria Hand takes over.”

May rolled her eyes. “I’ll cover the wards for you.”

He shook his head. “I can do it.”

*****

But the next morning, Coulson never showed up. Finally, Ward paged May.

“Where is Coulson?” she asked when she arrived.

“We don’t know. We tried paging him but he didn’t respond.”

“I didn’t see him in his office this morning,” Skye added.

May frowned. “We’ll round now, and then I’ll find out what happened to Coulson.”

They tried to focus on rounds, but they were all so distracted worrying about Coulson that it was hard to concentrate on their patients. Fortunately, May seemed distracted as well, and she went easy on them.

“I’ll find out what happened to Coulson,” May said once they had finished.

“He looked kind of run down yesterday. Maybe he’s really sick,” Skye said.

Hand walked briskly towards the team. “He’s very sick. He has tuberculosis.”

“Tuberculosis? Are you sure?” Ward asked.

“He said he just had a cold,” Skye said.

“The doctors at Centipede just diagnosed him. He collapsed this morning, and the ambulance took him over there.” She gave them a steely look. “Has he had any patients with tuberculosis recently?”

“We had a patient with multidrug-resistant tuberculosis a few weeks ago,” Ward said.

Hand looked angry. “So Dr. Coulson has been spreading multidrug-resistant tuberculosis around the hospital for weeks?” When no one answered she told Ward, “Call infectious disease. We need recommendations for screening and treatment for everyone who has been exposed.”

“What about Coulson?” Skye asked.

“He’s being treated at Centipede. Until he returns, Dr. May will be in charge of the residency program.”

“He’s not coming back here?” Skye asked.

Hand gave her a strange look. “There’s nothing that we can do for him that they can’t do over there.”

“Our patient had multidrug-resistant TB because of a drug trial being done over there,” Skye said. “We can’t just leave him with those people.”

“Those people are doctors. They will give him the same standard of care that he would receive here.” She surveyed the team and pursed her lips in disapproval. “I’ll be supervising this team starting tomorrow. Dr. May, can you supervise them for the rest of the day?”

May nodded.

“Then I’ll see you four tomorrow morning.”

After she left Skye looked angrily at Ward and May. “We have to do something. Peterson told me that those doctors running the trial didn’t do anything for him.”

May looked thoughtful. “Did you get a sputum culture on that patient?” Skye nodded. “Call down to the microbiology lab. Make sure they do not throw that plate away, and tell them to page you as soon as they get sensitivities. Then talk to Clint Barton for antibiotic recommendations.”

“So we’re not going to get Coulson back?” Skye asked.

“I'll handle that. Your job is to find out exactly what's wrong with him.”


	12. Outside the System

**Summary for the Chapter:**

> When Coulson is hospitalized for tuberculosis at another hospital, the team pulls out all the stops to get him transferred back to S.H.I.E.L.D. Meanwhile, Coulson is pressured to join the same drug trial that gave Mike Peterson multidrug-resistant tuberculosis.
> 
> Based on Season 1, Episode 11, "The Magical Place"

Barton looked surprised when he came into work and saw Skye sitting outside his office door.

“What are you doing here?” he asked.

Skye looked tired but triumphant. She held up a slightly wrinkled piece of paper. “The sensitivities from Peterson’s multidrug-resistant TB finally came back. Coulson probably has the same strain.”

Barton took the paper from her and studied it. He made a face. “Tough stuff,” he said. “Good work getting this. I’ll need to see if any of these interact with his immunosuppressants, but I can design an antibiotic regimen for him. Of course we’ll also want to get a culture from Coulson in case his strain has different sensitivities.”

Skye looked relieved. There had been so many drugs marked as resistant on the report that she had been afraid that they would not be able to treat him. “Thanks.”

“Is he back at S.H.I.E.LD.?”

“No. Dr. Hand won’t approve the transfer. She says that he’s getting fine care at Centipede, and we don’t have an open bed for him.”

Clint raised his eyebrows. “Fury and Stark won’t like to hear that. I’ll talk to them.”

Skye’s pager went off. “I should get back to the wards,” she said.

“Okay. Well I’ll take a look at his transplant medications and email you a regimen. You can pass that along to the doctors at Centipede while we’re waiting for the transfer.”

Skye nodded. Before she could say anything else her pager went off again. _Where are you? We’re rounding NOW. - Ward_

“Thanks,” she called over her shoulder as she jogged off towards the wards.

Hand was furious when Skye got to the office. “Where were you? We started rounds fifteen minutes ago,” she demanded.

Because of her role as medical director of the ICU, Hand made them round ridiculously early so that she would have most of the day free to do administrative work. Skye crossed her arms defensively. “I was taking care of a patient.”

Skye had hoped that Hand would leave it at that, but she demanded, “Which patient?”

“Coulson. I got the results of the TB sensitivities this morning, and -”

Hand cut her off. “Dr. Coulson is not one of your patients. His care is not your concern.”

“Of course it is. And he’s going to be one of our patients soon, right?” Beside her Simmons and Fitz also looked hopeful.

Hand shook her head. “I told Dr. Fury and Dr. Hill that the hospital is too full to justify the transfer. We have a long list of much sicker patients waiting for transfers to the ICU. Getting those patients here is the priority. Frankly I do not understand why there is so much insistence that Dr. Coulson be treated at S.H.I.E.L.D.”

“He’s one of us. He had his transplant here. All of his doctors are here,” Skye protested.

Hand stopped her. “I’m done talking about this. We need to start rounds.”

Skye lagged behind as Hand led the team to the first patient room. Ward slowed down to fall into step beside her. “Call over to Centipede,” he said quietly. “Give them the results of the sensitivities and the recommendations from Barton.”

“Okay. We need to get Coulson back here.”

“Well he can’t get over here until we have a bed, so we need to discharge as many patients as possible today.”

Fitz and Simmons overheard what they were talking about. “We have a few patients we can discharge today if they get their procedures done early,” Simmons said.

“We’ll call and get them moved to the top of the schedule,” Fitz said.

Up ahead Hand was standing impatiently outside of the first patient’s room. “Who has the patient in 601?”

Fitz hurried forward to start presenting. “That’s me.”

*****

Because of Hand’s lightning-fast style they were done with rounds in record time. Ward helped Fitz and Simmons get as many of their patients as possible ready for discharge. None of Skye’s patients would be able to leave for a few more days, so she took the opportunity to contact the doctors at Centipede. It took several calls before she was able to get ahold of someone who even knew who he was, and the nurse sounded reluctant to contact the doctor.

“Dr. Poe is very busy.”

Skye tried to sound as authoritative as possible. “I’m a doctor at S.H.I.E.LD. with important information about one of his patients. I need you to page him right now.”

After a moment’s pause the nurse said, “All right. I’m paging him now to call you back.”

Hours later, though, Skye still had not heard from the doctor. By the time Ward, Fitz, and Simmons returned to the office, Skye was pacing around the office debating whether she should just drive to Centipede after work.

“What’s wrong?” he asked.

“I tried to get in touch with the doctors at Centipede, but no one will call me back. I paged them hours ago.”

“Maybe they’re just busy,” he said, but he also looked concerned.

“That’s not very reassuring though,” Fitz said. “We all get paged at all hours of day or night to talk to our patient’s doctors or family members, and we always call them right back.”

Simmons nodded. “I think this and what happened with Mr. Peterson shows that this isn’t the kind of hospital Coulson should be in.”

The three of them looked at Ward expectantly. “He’s on the transfer list. All we can do is keep discharging patients to make a bed for him.”

“It doesn’t matter how many we discharge,” Fitz complained. “You heard Dr. Hand on rounds. She’s in charge of triaging the outside hospital transfers, and she doesn’t think Coulson is a priority.”

“Maybe Dr. May could help move him up the list?” Simmons suggested.

Ward shook his head. May had tried, but she had not had any luck getting that approved by Hand. “That’s not her job. I’ll talk to Hand again.”

When he got to Hand’s office he had to wait outside while she finished meeting with Dr. Clark Kent from surgery. As soon as Kent left, Ward knocked on her door.

“Excuse me, Dr. Hand? Do you have a minute?”

“Only just,” she said. “I have a meeting in five minutes. Is this about one of the patients?”

“It’s about Coulson. I know that he is being treated at Centipede, but from what we’ve seen he’s not getting adequate care. Centipede isn’t set up to take care of transplant patients, and when we’ve tried to give them information that will help treat him, they won’t listen to us.”

He hoped that his argument would convince her, but her eyes narrowed. “Who has had the time to contact Centipede about Dr. Coulson?”

“Skye did. I told her to,” Ward said.

“We are in a bed crisis here, Dr. Ward. I have to think about not just the patients in this hospital but the entire community. Triage decisions cannot be made based on sentiment. Our beds are valuable and go to the patients who need them the most. Dr. Coulson is on the list of patients to be transferred in, but I cannot in good conscience place him at the top of that list. Just because he’s a doctor here does not mean that he deserves special treatment. Now, I have a meeting with the Chairman of Pediatrics to see if they can spare us any beds. You should get back to work.”

“Yes ma’am.”

“And Dr. Ward, if Skye has enough time to waste calling about Coulson, then she has enough time to finish her charting. I saw her name on the list of interns who have incomplete charts. The hospital does not get paid until all of the charting is done. Make sure she’s finished by the end of today.”

*****

“Good, you’re awake.”

Coulson turned towards the door. “Dr. Poe.”

Poe scowled at him. “I was hoping that you would be in a more cooperative mood today. Have you reconsidered my offer?”

“To enroll in your drug study? No thanks.”

“Dr. Coulson, we both know that this strain is quite virulent and will require a carefully-designed treatment regimen. That is what we are offering you. And in exchange, all we ask is that you help us further our research.”

“Your research produced this strain. Your antibiotics don’t work. When Mr. Peterson left S.H.I.E.L.D., he was fine. Now, thanks to you, he’s back in the hospital and away from his son.”

“We gave him those drugs for free, drugs that he otherwise would not have been able to afford.” His soft voice held a sinister undercurrent. “You’re just upset because he reminds you of your own father. Dead from a heart attack when you were just a boy.” Coulson tried not to react, but he felt his face twitch. As if sensing Coulson’s question, Poe added, “We got your medical records from S.H.I.E.L.D. With such a serious family history of heart disease, I would have thought you’d take better care of yourself.”

Coulson stared at Poe defiantly. “I’m not interested in your study.”

Poe’s scowl deepened. “I’ll be back to discuss this with you again later.”

*****

S.H.I.E.L.D. might be a top biomedical research facility, but it still used an archaic computer system. In order to finish incomplete charts after patients were discharged, interns had to use one of the computers in medical records. Skye wandered through the basement for almost half an hour before finding the office. The woman at the desk pointed her towards rows of old PC’s.

“We were wondering when you’d make it down here. Work there. The office is open 24 hours. Here’s a list of your incomplete charts.”

Skye groaned when she saw the list. There was no way she would get done in a single day. Some of the charts were from as far back as July. After several hours she had only made it through a quarter of the list, but she desperately needed to take a break and go to the bathroom.

On her way back from the bathroom she heard someone watching TV in the office next to medical records. Curious, she poked her head in the door.

Skye caught a glimpse of an episode of Archer before the guy quickly closed his Netflix window. “Oh, hey. Are you from tech support?”

Besides the computer that he had been watching TV on, there were several other computers in the office displaying maps of the hospital. There was a nameplate on the desk that said: Lloyd Rathman, Bed Management. “No, I’m a medicine intern. You’re with Bed Management?”

Rathman puffed out his chest. “I am Bed Management. I control every bed in this hospital.” He eyed her up and down. He seemed to like what he saw because he said, “When are you on call? Because I could make sure you don’t get many admissions that night.”

“Thanks, but that’s okay. So do you handle outside hospital transfers too?”

“Yep. The departments give me a list of who to accept and in what order, but they rely on me to coordinate the transfers.”

He sounded so proud of himself that Skye almost burst out laughing. She, Fitz, and Simmons had often complained about Bed Management, which Fitz described as a job a monkey could do.

The phone rang, and he picked it up. “Bed Management. Uh-huh. Uh-huh. Okay, got it. I don’t know. Yeah, the system is still down. There might be a bed opened up, but I won’t know for certain until I get the system up and running. Okay. Bye.”

Skye perked up when she heard him mention opening up beds. “You know, I’m pretty good with computers. Maybe I could help.”

“It’s pretty complex,” he said, but he moved aside so Skye could take a look. It did not take her long to figure out how he had gotten the system in a tangle and only a few additional minutes to untangle it.

“There, that should work.” She pressed a few final keys, and the map of the hospital, which previously had been covered with flashing boxes became more orderly.

He looked impressed. “Thanks.”

“So what does all this mean?”

“The map shows every bed in the hospital. It’s color-coded by department. You’re medicine right? That’s blue.” He pressed a button and all of the colored squares disappeared except for the blue ones. “The open rooms have white in the center.” There were no open rooms on the map.

“What about the dotted lines?” Skye asked.

“Those are oncology beds. There are a few scattered on the medicine floors for scheduled admissions to get chemo or something. Actually that’s what crashed the system.”

“What do you mean?”

“Well I got called by one of the oncologists to cancel some of the scheduled admissions because of the bed crunch, but the system crashed when I was making the changes. Don’t go anywhere until I see if I can get that to work again.” He pulled up an email, and Skye noticed that it was from May. Rothman input the information into the system, and one of the oncology beds turned white. “Cool. Thanks for your help.”

“So who’s going to get that bed?”

He pulled up a list of pending transfers. “Hmm, well all the pending oncology transfers and admissions have gotten beds, so it’ll go to the next medicine patient.” Skye was dismayed to see Coulson’s name near the bottom of the medicine patients.

“What does that little A in the corner mean?” Skye asked.

“It’s an airborne isolation room,” he explained.

Skye smiled to herself. Perfect. “Actually that guy is supposed to be on the oncology list,” she said pointing at Coulson’s name.

“Really? Who’s the accepting attending.”

“Melinda May. She’s my attending.” Skye crossed her fingers that he wouldn’t ask too many questions.

“I don’t have an email about that,” he said.

“Well why do you think she was trying to clear out the beds?” Skye asked.

Rothman shrugged. “Whatever. Just have her send me another email to confirm, and I’ll put the transfer orders through.”

*****

The isolation was starting to drive Coulson insane. Because of the tuberculosis he had to stay in his airborne isolation room at all times. The only people he saw were the nurses and Dr. Poe. He was trapped.

Lying in his hospital bed, unable to sleep, he thought about an article he had read about post-traumatic stress disorder in survivors of ICU stays. At the time he remembered scoffing at the article. They saved lives in the ICU. A few nightmares seemed like a small price to pay. However it did not feel like a small price as he tried to relax enough to drift off to sleep. His heart felt like it was going to burst out of his chest. Every time he closed his eyes he had flashes of memories from the ICU - being tied to the bed, unable to speak or scream because of the plastic tube down his throat.

There was a soft knock on the door, and a dark-haired woman entered. “Dr. Coulson, I’m Raina. I’m taking over your case.”

“What happened to Dr. Poe?”

“He’s been removed. Our supervisor was unhappy with how he was handling your case.” She smiled at him. “How are you feeling?”

“I’ve been better.”

“We have you on an antibiotic regimen, but since you are still resisting entering our clinical trial, we cannot give you our new drugs.” She never lost the gentle smile, but Coulson was not comforted. “I’d be happy to sign you up right now.”

“I want to be transferred back to S.H.I.E.L.D.,” he said. “I had a heart transplant, and my doctors are there.”

Her smile faded. “We know all about your transplant. I have your chart right here. It told me everything about your illness and recovery. The bloodstream infection you battled, the second cardiac arrest in the ICU. It says that they broke two ribs in order to resuscitate you. It also says that they tested your brain function after the arrest. Some of the doctors thought you might be brain dead because of how long you were down for.” She paused to let her words sink in. “Six weeks in the ICU is a very long time. Do you really want to go through something like that again?”

He wondered if she knew about the nightmares. The nurses could have noticed him tossing and turning at night.

“They’re my friends. They saved my life.”

“They’re doctors. They know a hopeless cause. But they lost their objectivity with you. Do you really trust them with your life? Do you trust them to make the right medical decisions? You don’t have a medical decision maker. You don’t have any family. The next time you end up in the ICU at S.H.I.E.L.D., all you’ll have are your colleagues, putting you through every possible medical procedure, no matter what the cost.”

He did not say anything. Deep down he had been thinking the same thing. He had wondered how long Fury and Stark would have kept him in the ICU hooked up to machines, waiting for a miracle. Despite the sedation, he had a few memories of lying in the ICU, struggling against the intubation and wishing that they would just let him go.

He tried to keep his face neutral, but he could feel his composure cracking. “Your antibiotics don’t work.”

“You shouldn’t make those kinds of allegations without proof. We can try to treat you outside of the study, but your strain is very complicated. It could be difficult to find an effective regimen.”

“I want to talk to Clint Barton. He’s an infectious disease specialist at S.H.I.E.L.D.”

“Another one of your S.H.I.E.L.D. friends,” she said. “He doesn’t have privileges here. And the last time I spoke to someone at S.H.I.E.L.D., I was told that they’re completely full. It could be weeks before they have a bed for you.”

He looked down. “I’ll sign up.”

Raina smiled. “Excellent. I’ll bring over the research contract this afternoon. You’ll need to sign a confidentiality agreement, and all information and culture samples become property of our group.”

That explained why they were so desperate for him to sign up. They would not want to include the results of a patient on immunosuppressants in their study, but enrolling him would ensure that there was no evidence there that their drug regimen had created multidrug-resistant tuberculosis.

As she left, she said, “I’m glad you finally see that this is the best outcome for everyone.”

*****

When Skye got back to the office May was waiting for her. Skye expected her to be furious, but May merely raised her eyebrows. “I got an email asking me to confirm that I had accepted Coulson onto the oncology service.”

“Yeah, about that -” Skye began, but May interrupted her.

“Good thinking. How did you get that through the system?”

“I met the guy who runs Bed Management. His name’s Lloyd. He’s down in the basement.”

“I always wondered where he was,” Ward said. He looked cautiously at May, “So you’re okay with this?”

“I’ve already sent the confirmation,” May said. “Coulson will be here soon.”

Just then Victoria Hand came into the office. She looked furious.

“You,” she said to Skye. “I should have you thrown out of the residency program for that stunt you pulled. What makes you think you can get away with manipulating the system like that?”

Before Skye could say anything May said, “She was acting on my instructions. I have admitting privileges to this hospital, same as you.”

“For oncology patients. Coulson is not an oncology patient.”

“That’s my call.”

“And you’re proud of yourself? Canceling other patients’ chemo treatments to transfer one man back?”

“I didn’t cancel anyone’s treatment. Those patients will be getting the same therapy in the outpatient clinic.”

Hand stared at May with an intensity that would have made Skye tremble, but May looked as impassive as ever. “Fine,” Hand said. To the interns she said, “I expect one of you to be ready to present his case tomorrow morning.”

“No,” May said. “I accepted him. The residents will take care of him under my supervision.”

Hand stared at May coldly, but then turned back to the interns. “Now that you’re finished disobeying my orders, I expect your charts to be done by the end of the day,” she reminded Skye. “I’ll see the rest of you early tomorrow morning.” She stormed off without another word.

Fitz and Simmons looked terrified. “How much longer is she going to be our attending?” Fitz asked.

“I’ll see if I can switch with her,” May said. “She’s not fond of being on the wards anyway.”

*****

The next day after they finished rounding with Hand, Ward paged May, and they all went to round on Coulson. 

“And based on the sensitivities, I talked to ID, and they recommended this regimen. He’ll need weekly sputum cultures to see when he’s no longer infectious. In terms of his transplant, his prograf level was high when he arrived, so I’ve talked with Dr. Stark about adjusting the dose while he’s on antibiotics. He’ll get another level checked tomorrow.”

“Good job,” Ward said. “I don’t have anything else to add.”

“Let’s go see him,” May said.

Fitz made a face but did not protest. Skye and Simmons giggled as Fitz put on the isolation suit. It looked like a paper spacesuit and had a fan that blew purified air across his face so he did not breathe in any particles inside the room.

“Don’t laugh at me,” he said. “At least I know I’m protected from infectious particles in this suit. It’s very effective.”

“We just want you to be safe Fitz,” Simmons said hiding her smile behind her mask.

Coulson looked tired but pleased to see them. “It’s nice to see some familiar faces. I heard about everything you did to get me back here and on the right antibiotics. Thank you.” Although he was smiling there was sadness in his eyes as he said, “I don’t know what I did to deserve such caring colleagues.”

“It was nothing,” Ward said.

Skye squeezed his hand. “Of course you deserve it. You’re our attending. You’ve done so much for us.”

“Thank you,” Coulson said. “I’m just glad to be back. I suppose I’m going to be here for a few weeks at least.”

“Don’t worry, we can bring you things to keep you entertained. What sort of things do you like to read?” Simmons asked.

Before he could answer, May stepped forward and wordlessly handed him a stack of Captain America comic books. His face broke into a grin. “My favorite.”

It was a little hard to tell behind the mask, but Skye swore that May gave him a fond smile.

“I’ll be fine,” he told the team. “Now don’t you all have other patients?”

Skye was the last to leave. Before she stepped out the door he stopped her. “Skye. I heard about what you did with Bed Management to get me transferred over here. Thank you.”

“Anytime. Are you okay?” she asked.

“I’m fine.” He gave her a sad smile. “I’m just a little tired.”

“Okay. I’ll let you get some rest. But I’ll come by to check on you this afternoon. Hey, is it weird having me as your doctor?”

Coulson smiled and shook his head. “I’m lucky to have you taking care of me.”


	13. Holiday Party

**Summary for the Chapter:**

> Fitz, Simmons, and Skye throw a holiday party for the medicine residents.

**Notes for the Chapter:**

> Like "Thanksgiving" this is just a fluffy interlude between the episode-based chapters.

Coulson was pleasantly surprised to receive an invitation to the holiday party that Skye, Fitz, and Simmons were throwing. He had recently been discharged after being treated for tuberculosis, but he would not be able to return to work for another few weeks, and being stuck at home was slowly driving him crazy. He was so excited to have some place to go that he was the first to arrive.

Skye answered the door wearing reindeer antlers. “Hello Skye,” he said with a smile. “Merry Christmas.” He handed her a bottle of wine that he had picked up on his way there.

“Thanks. Why don’t you take that into the kitchen? I’ll take your coat upstairs. Sorry, we’re not completely ready yet.” She took his coat upstairs while he wandered into the kitchen. Simmons and Fitz were laying out plates of Christmas cookies, cheese and crackers, and other snacks. Lined up along the counter was a huge array of alcohol, and he set his bottle of wine between a bottle of peppermint schnapps and a bottle of Goldschlager.

“Hello Dr. Coulson. Would you like a drink?” Simmons asked.

“Looks like you have quite an assortment.”

“We’re making a holiday apple cider punch, but we have some other things too in case people want something else. We also have hot chocolate on the stove and beer in the fridge.”

“I’m okay for right now. Is there anything I can help you with?”

“Do you mind making the holiday punch? The recipe is pulled up on Skye’s iPad. All the ingredients should be out on the counter,” Fitz said.

Coulson studied the recipe and started assembling what he needed to make the punch. He raised his eyebrows when he saw that the recipe called for Scotch and was even more surprised when he saw the bottle of single malt on the counter.

“Are you sure you want to put this in the punch?” Coulson asked. “This is a pretty good bottle of Scotch.”

“It was a graduation present from my uncle,” Fitz said, “but none of us drink Scotch.”

“It’s what the recipe calls for,” Simmons said.

Coulson shrugged and poured half of it in. But when he tasted it, it just tasted like apples, so he added the rest of the bottle as well.

“Are you all working Christmas or New Years?” he asked. The hospital ran a skeleton crew so that all residents could get either six days off over Christmas or New Years.

“We’re covering Christmas,” Simmons said.

“Christmas is usually easier to work. Not as busy,” Coulson said.

“That’s what Ward said. None of us had have any plans for Christmas, and some of the other residents really wanted to be at home.”

“Are you doing anything for New Years?”

“My parents are coming into town and staying with me and Fitz. I’m so excited to see them. I haven’t seen them since intern year started, and we haven’t even been able to Skype the way we used to when I was in medical school and college.”

“That’s nice that they’re coming then. What about you Skye?”

“I’m just hanging out here.”

Coulson looked surprised. “You’re not going back to Texas?”

Skye shook her head. “No. My dad and I aren’t really that close. He’s probably going to be working the whole time, plus we’d probably end up getting into a fight about residency. I’d rather just relax here and not have to deal with that.”

“Well you’re more than welcome to come to dinner with my parents when they’re visiting,” Simmons offered. “We’re going to have a nice dinner for New Years.”

“Thanks but I’ll be fine just taking it easy.”

*****

By the time Ward arrived the party was in full swing. It seemed like every medicine resident was there. He felt a little uncomfortable partying with his interns, but he reasoned that it was almost halfway through the year. He could afford to relax in front of them. Besides, between the stress of work and trying to figure out what was going on between him and Melinda May he needed to blow off some steam. He made his way through the crowd for the kitchen to get a drink.

“Grant! Glad you could make it,” Simmons said.

“Want a drink? We have some apple cider punch,” Fitz asked.

“Maybe later. Got any beer?” Fitz pointed at the fridge, and Ward grabbed one.

He laughed when he saw the array of alcohol on the counter. “Are we going to do shots of Goldschlager later?”

“Maybe,” Skye said as she came into the kitchen. “You up for that?”

Simmons looked annoyed. “No! That’s for the hot chocolate. It’s festive.”

The oven timer went off. “Oh! That’s the baked brie. Help me get it out of the oven,” Simmons said. Ward watched in amusement as they wrestled the baking sheet out of the oven.

“Be careful, it’s hot,” Simmons warned.

“I’m being careful, but you’re not holding your side up high enough. It’s going to slide right off.”

“Sorry. There, that’s better. Now where should we put it?” Simmons scanned the counter which was already covered with drinks and other snacks.

“There’s a spot over there by the dishwasher.” As they were trying to maneuver the baking sheet to the one empty square of counter space, the doorbell rang.

“Oh Grant, can you get that?” Simmons asked.

“Sure.” He grabbed his beer and went to the front door. He was surprised to see Melinda May on the other side. He stared dumbly at her.

“Are you going to let me in?” she asked.

“Oh. Sure. I, uh, didn’t realize you were coming.”

“Coulson said I should make an appearance.” She stared pointedly at him, but he did not budge.

“Oh. Um, you know I’m not doing anything later, if you wanted to....”

“Maybe.” Her face was impossible to read.

“Okay.” He stepped aside to let her in.

“Hi Dr. May,” Skye said. “Do you want a drink? I can take your coat.”

“Thanks.” May handed her coat to Skye, who promptly threw it to Ward and gestured for him to take it upstairs.

“There are drinks in the kitchen. We have a special apple cider punch.”

“Is there anything less festive?”

Coulson came up behind Skye. “The punch is actually pretty good.” He handed her a glass.

It was not as saccharine as she thought it would be. “It tastes like juice.”

“I know, but it has alcohol in it.”

She took another sip. “It doesn’t taste very strong. What’s in it?”

“Apple cider, apple brandy, Scotch -”

She gave them a look. “Who would put Scotch in punch?”

“It’s what the recipe called for,” Skye said defensively.

Coulson spotted Ward coming down the stairs. “Hello Grant. Have you tried the punch?”

“No, I’ve been sticking with beer.” He held up his nearly empty beer.

“Aw, you should try some,” Skye said. “I found the recipe online, and it’s so good.”

“Okay. Does anyone want anything else?” he asked. Skye, Coulson, and May shook their heads, and he headed back to the kitchen. He felt awkward being around May at the party and decided that the best thing was to avoid her for the rest of the night. After he got a glass of punch, which was tastier than he thought it would be, he joined Logan, Scott Summers, and Jean Grey.

*****

The first sign of trouble was Ward making a scene by the punch bowl. As he tried and failed to refill his cup of apple cider punch he asked loudly, “Wait what? Which OB/Gyn residents?”

Gwen Stacy laughed. “Half of my intern class. I could set you up with one of them if you want.”

“Oh, uh, I don’t know if that’s a good idea. I’m kind of seeing someone.” His words were loud enough that they filled the room, earning a glare from May that Ward was too drunk to notice and an excited shriek from Skye.

“Oh my god!” Skye exclaimed. She ran across the kitchen and grabbed his arm. “You have a girlfriend? Since when? Who is it?”

“I probably shouldn’t say. I mean, she’s not really my girlfriend. I don’t really know what’s going on.”

Skye laughed too loudly and stroked his arm. “Poor Grant. Tell the truth: is she your imaginary girlfriend?”

Ward looked like he was pondering that question carefully. He tried to refill his apple cider punch but stumbled and fell against the table.

“I think some of the residents have had too much to drink,” Coulson told May.

“Someone should get them to stop drinking that punch and go home,” May said.

“I’m afraid it’s my fault,” he confessed. “I mixed the punch. The recipe called for half a bottle of Scotch, but when I tasted it, it didn’t seem very strong, so I added the rest of it.”

She gave him a look. “Big mistake.”

Ward spotted them standing in the corner and lurched towards them. “Dr. May, Dr. Coulson,” he said.

“Feeling all right, Grant?” Coulson asked.

Ward nodded. “Great.” His eyes were having trouble focusing on them.

Coulson and May exchanged a look. “Do you want me to call you a cab?” he asked.

Ward leaned against the wall and squinted a little. “No, I’m okay,” he said.

“I really think you should go home, Grant,” Coulson said firmly. “Get some sleep.”

Grant started to protest again, but May rolled her eyes at Coulson and gave him a nod. While Coulson called a cab, she led him into Fitz’s bedroom where all the coats were piled on the bed. She waited impatiently as he dug through the pile until he pulled out his fleece jacket. He smiled goofily at her as he put it on.

“You’re so pretty.”

May’s scowl deepened. “Not here. You need to go home.” She dragged him out the door and helped him flag down a cab.

While they were waiting he wrapped his arms around her and kissed her. “You could come with me,” he said.

She pulled away. “You’re too drunk. Are you off tomorrow?” He nodded. “Good. I’ve never seen you this drunk before.”

He shrugged. “Just blowing off some steam. You know.”

“Next time don’t blow off quite so much steam.” At last a cab stopped in front of them. May helped him into the backseat and gave the driver his address and enough cash to cover the fare. “Do you have your keys?”

He rummaged through his pockets and held them up proudly. “Thanks for taking care of me Melinda. You’re so nice.”

“Drink plenty of water when you get home,” she said before she shut the door. She watched the cab drive off towards Ward’s building and wondered if she should have gone with him. He was pretty drunk, but not so drunk that he could not get in his front door on his own.

When she got inside Coulson was taking care of some of the other residents. The holiday punch had put most of the residents over their limit, and it was not long before the party broke up completely. The residents left in groups, sharing cabs back to the various parts of DC or walking back to the metro, until only Skye, Fitz, and Simmons were left.

“Do you have a way to get home, Skye?”

“I was going to spend the night,” Skye said.

“Where did everyone go?” Fitz asked. “It’s still early.”

“Ooh, we could do more shots of Goldschlagger,” Skye suggested. “There’s still most of the bottle left.”

May rolled her eyes.

“Maybe another time,” Coulson said. “You should go to sleep. I think Jemma is already asleep.” He nodded towards the couch where Simmons was curled up with her eyes closed.

Fitz went over to her and shook her. “Jemma? Jemma? Wake up.”

“Ungh, I’m awake,” Simmons said groggily.

“Come on,” Coulson said. He helped Simmons to her room while May led Fitz upstairs. When he got downstairs May was looking for blanket for Skye.

“Lie down on the couch, Skye,” Coulson said. He pulled her shoes off and tucked the blanket that May had found over her.

“They’re going to be very hungover tomorrow.”

“We should leave them some water and aspirin,” he said.

May went upstairs to look for aspirin while Coulson went to the kitchen to pour glasses of water. When May came downstairs with Skye’s aspirin, she found five glasses on the kitchen counter. “One for each of us too,” Coulson said, handing her one.

May took hers without comment. As much as she hated to admit it, she was feeling quite tipsy from the punch. Once they finished and left water for Fitz, Simmons, and Skye, they headed out. “I’ll walk you home,” Coulson said as they left Fitz and Simmons’ apartment.

“You don’t have to do that,” May said. “I live on the next block.”

“I’d like to,” he said.

“I’m not drunk.”

“Please, just humor me.” He looked at her expectantly, and finally she nodded. As they walked down the street he said, “It was nice seeing you tonight.”

“We saw each other every day when you were in the hospital.”

“When I was in the hospital, you saw me as my doctor. We used to eat dinner together and go out for drinks after work, but we haven’t done anything like that in a while. I miss that.”

She was quiet, and he worried that he had said too much. But finally she said, “I do too.”

When they got to her place, she asked, “Do you want to come in?”

“Sure.”

She let them in and went into the kitchen for two more glasses of water. Annoyingly, Coulson seemed to be the only person at the party who had not been affected by the punch, although he accepted the glass she handed him.

“Thanks,” he said. They sat down next to each other on the couch. “I’m glad you came to the party. I’ve been wanting to talk to you since Thanksgiving.” He paused as if waiting for her to say something, but when she did not, he continued. “Maybe I should have told you that Jenny accused me of having an affair with you, but I didn’t want you to feel guilty. Things with Jenny and me would never have worked out. Our marriage was over when I took the job as chief resident. You were just an excuse, something else for us to argue about.”

She gave him a look. “Why did you moved in with me?”

“I didn’t have anywhere else to go,” Coulson said. She glared at him, and he admitted, “I liked living with you. You were my best friend.” He looked down and sighed. “Maybe I never told you because I couldn’t face my own guilt. Even though nothing happened between us, I had feelings for you that I shouldn’t have had. I didn’t want you to feel guilty because of my mistake.”

She was not sure what to say. She had suspected that he had feelings for her, but she had never been certain, and she never expected him to admit it. “You didn’t do anything wrong,” she said.

“I did. I fell for another woman even though I was married. I knew nothing could ever happen between us - I was married, then getting divorced, and you were moving to Houston at the end of the year. But I couldn’t help it.”

She touched his hand. “It was a long time ago. We don’t need to go over it again. A lot has happened since then.”

He nodded and smiled at her. “Working with you on the residency program reminded me a lot of that year. I was lucky to have you as a friend. I am lucky.”

“Me too.”

“I like being able to tell you things. I don’t like keeping secrets from you.”

She looked away for a moment, then turned back and said, “Grant and I have been having sex.” She waited for him to react, but he only raised his eyebrows slightly. Finally she said, “Well?”

“Well what?” He paused, then asked, “Is it serious?” When she shook her head, he shrugged a little and said, “You know what you’re doing.” He stood up. “I should go.”

“Are you going to call a cab?”

“No, I drove Lola.”

“Should you really be driving?”

He smirked a little. “I’m fine. Unlike the rest of you.”

“You might not be drunk, but should you really be driving Lola after drinking that punch?” She knew that he was always very careful with Lola.

“I don’t want to have to come back in the morning to get her.”

“Stay here. I’ll get you some blankets, and you can sleep on the couch.”

“All right. Thanks. In the morning, we can get brunch just like we used to in residency.”

“I’d like that.”

*****

Skye groaned and slowly opened her eyes. She had not been this hungover since medical school. Fortunately, someone had left a glass of water and some aspirin on the coffee table. She swallowed the pills and drank the water, then gathered the blanket around her and wandered around the house.

Fitz and Simmons were in the kitchen. They looked as terrible as she felt.

“Thanks for the water and aspirin,” Skye said.

Fitz shook his head. “That wasn’t us.”

“Both of us had water and aspirin on our bedside tables,” Simmons said, “but neither of us put it there.”

“Then who?” Skye asked.

Simmons looked uncomfortable. “I think it might have been Dr. Coulson. I have this vague memory of him helping me up the stairs and telling me to take my shoes off.”

Skye frowned. “I think I remember something like that too - Coulson telling me to lie down on the couch and taking my shoes off.”

“Oh god,” Fitz moaned. “I was hoping it was just a bad dream.”

“It’s not that bad, Fitz,” Simmons said, although she looked pretty mortified. “I’m sure he’s seen plenty of bad behavior from residents before.”

“It’s not that big of a deal,” Skye agreed. “Maybe we should get something to eat. I could use some coffee, and greasy food is good for hangovers.”

“There’s a good brunch place not far from here. We can walk down there.”

Although they all squinted in pain when they went outside, the old air actually made them feel a little better. By the time their food arrived, the aspirin, water, and coffee had them feeling almost human again.

“Oh my god,” Simmons said, dropping some of her eggs back onto her plate.

“What?” Skye asked.

Simmons lowered her voice. “Dr. Coulson and Dr. May are over there.”

The other two paled. “What are they doing here?” Skye asked.

“Having brunch. I knew she lived nearby, but I didn’t know that Coulson did as well.”

“Maybe he spent the night at her place,” Skye said.

Fitz grimaced.

“Not like that! Or, okay, maybe like that, but maybe he was just too drunk to drive home or something.”

They had hoped that May and Coulson had not noticed them, but after they paid, Coulson and May came over to their table. Fitz stared at the floor, and Simmons turned bright red.

“Good morning,” Coulson said. “How are you doing?”

“Okay,” Skye said, “thanks to the water and aspirin you left us.”

“You’re welcome. Melinda and I were just talking about how much we enjoyed your party last night.”

“Oh, good,” Skye said. “I’m glad you guys had fun.”

They all waited to see if he would say anything else about the party, but he just smiled and said, “Enjoy the rest of your weekend.”


	14. Who Do You Become

**Summary for the Chapter:**

> A group of MD/Ph.D. students arrive from Harvard to do an away rotation at S.H.I.E.L.D. Meanwhile, Coulson and May look into the truth about Skye’s mother.
> 
> Based on Season 1, Episode 12, “Seeds”

Coulson had arranged for medical students from Harvard to rotate through S.H.I.E.L.D. in January, but when the time came for them to start he was still on medical leave because of his tuberculosis. Since Maria Hill was covering the team, it fell to her to explain the new program to the residents.

“These are some of the first med students to ever rotate at S.H.I.E.L.D, and we’re hoping to recruit the best of them to come here for residency. In order to show the strengths of this program, they are going to be functioning as sub-interns. The computer system will allow them to put in orders and write notes under your name, but you will need to co-sign everything. Each intern will have one student to supervise on call.”

“Isn’t that dangerous? They’re not real doctors yet,” Ward said.

“They’ve all been sub-interns before, and they know to run everything by you guys. The worst that will happen is you’ll have to answer a lot of questions about dosing tylenol and ordering diets,” Hill said.

“I’m sure it will be fine. The med students are from Harvard, and our sub-internship there was very thorough,” Simmons said.

Skye tried not to roll her eyes. Fitz and Simmons were very proud of their alma mater, but Skye did not think it was a huge deal. After all, she had gone to the University of Texas at Galveston, and they had all wound up in the same place. “We’ll look out for them,” she told Hill. 

“Excellent. You’ll be getting Seth Dormer, Donnie Gill, and Callie Hannigan,” Hill said.

“Do you and Fitz know these guys from med school?” Skye asked. Fitz and Simmons shook their heads.

“Their names are familiar. I think they’re all in the MD/PhD program too, but we’ve never met them,” Fitz said.

“Since Fitz is on call today we’ll let them decide who wants to take call when,” Skye said. She remembered how miserable it had been taking her first call without a change of clothes or even a toothbrush.

When Simmons asked which of the medical students wanted to be on call that day with Fitz, Donnie Gill immediately raised his hand. Skye and Simmons exchange an amused smile.

“Are you sure?” Simmons asked. “You won’t be able to go home until tomorrow afternoon. It’s a 30 hour call.”

Donnie lowered his hand and looked embarrassed. “Uh, that’s fine.” He stared at his feet.

“Wonderful. I’m glad you volunteered. Skye will be on call next on Friday, and I have the Sunday call. Who wants to be on with us?” After some hesitation Seth agreed to be on call with Simmons while Callie took Friday with Skye.

Donnie went over to Fitz who was playing Sporcle trivia games on one of the computers.

“I guess I’m going to be on call with you today.”

“Okay. I’ll let you know when I get a new patient.”

“Thanks.” Donnie sat down at the computer next to Fitz. “Should I start reading up about some diseases?”

“No. We’ll see what we get. It could be anything.”

“Oh.” He was silent for a minute and then blurted out, “I did my PhD work with Dr. Weaver. She said that you and Jemma were the smartest med students to come through the MD/PhD program.” 

“Thanks. You must be pretty smart yourself to work with Dr. Weaver. I didn’t know she took MD/PhD students in her lab. How come we didn’t meet at Harvard?”

“I mostly keep to myself. Dr. Weaver said that she tried to get you and Jemma to stay at one of the Harvard programs for residency. Why did you come to S.H.I.E.L.D. instead?”

Actually Fitz and Simmons had ranked a number of programs higher than S.H.I.E.L.D., including both MGH and the Brigham, but he did not want to admit that to Donnie. “It just worked out that way. They have a lot of amazing research here, and Dr. Coulson is reforming the program so we have more access to the attendings. The doctors here are at the top of their field.”

“Do you like it here?”

“Yeah, I do, although things are a lot messier on the wards than in the lab. Dr. Coulson is a great advocate for the residents.”

“That sounds great,” Donnie said. “Dr. Weaver said that she wasn’t sure about my chances to stay at MGH or Brigham. I didn’t do so well on my clinical rotations.”

“I didn’t either,” Fitz admitted, “but things have a way of working out.” He checked his pager. “Looks like we got our first admission. Let’s see what we’ve got.” Donnie peered over his shoulder as they read through the ER chart. An elderly demented man had been found wandering the streets of DC alone. Fitz looked apologetic. “Sorry, it’s not the most exciting case, but you need something to present on rounds tomorrow. Be sure to talk to the family to get a history.”

Donnie nodded. “All right. I’ll let you know when I’m done so we can talk about the case.”

Before he left the office Seth grabbed his arm. “Hey, don’t forget our meeting with Dr. Quinn at 5,” he says quietly. “We don’t want to blow this opportunity.”

Donnie nodded. “I won’t. I’ll meet you here.”

*****

When Coulson answered the door, he looked surprised to see her. “Melinda, what are you doing here?” he asked as she came in.

“I’ve been looking into Skye’s background like you asked. I have the day off, and I thought we could work on it today.”

“Why did you come by? Why didn’t you call?”

“You haven’t been answering,” May said. She gave him a pointed look. “I left you a message.”

“I haven’t really felt like talking,” he said.

“I’ve been trying to talk to people who were residents at S.H.I.E.L.D. with Skye’s father. Most of them have scattered across the country, and the ones who are still at S.H.I.E.L.D. wouldn’t talk to me. But one of the surgical interns under him is now working at Johns Hopkins. I thought that we could go there and talk to her.”

“Why are you doing this?” Coulson asked. “When I told you, you didn’t seem very interested in looking for Skye’s mother.”

“She did a lot for you when you were sick,” May said.

“I know.” May kept looking at him expectantly, so finally he sighed and said, “Let me get my coat.”

Even though it was winter, Coulson insisted on driving them in Lola. May rolled her eyes but did not protest.

“We could get a drink at the Waterfront Hotel after we talk to her. It would be like old times,” May said. Coulson did not reply. “Clint would be disappointed if we went without him. He loved that bar. Do you remember how he used to hit on the actresses who stopped by after filming Homicide?” She paused, but he was still silent. “Maybe he can meet us after work.”

He glanced over at her. “You’re talking more than usual.”

“Because you’re not. Something’s bothering you.”

Coulson sighed. “It’s not important.”

“Yes it is. What’s wrong?”

He hesitated, unsure whether he could share this with her, but finally said, “I know that I should be grateful for everything that happened after my heart attack, but I can’t shake the feeling that there was something wrong about it. I read through my chart while I was at Centipede. I don’t know if I would have made the same choices to push ahead and wait for a transplant.”

May felt a pang of guilt. She remembered also doubting whether it was worth keeping him on life support. It had taken six weeks for him to get the new heart, and so many complications kept piling on. It had seemed like he would certainly die before the transplant came through. “It was a tough situation Phil, but everything worked out in the end.”

“This heart that they gave me, it came from someone. Someone died so that I could have a second chance. I don’t know if that was the right call.”

“What do you mean?”

“I don’t have a family. No one would miss me if I died. When they gave this heart to me, what happened to all the other people who were waiting?”

“You may not have a family, but people would miss you if you died. You’ve done a lot with your second chance. You deserve it as much as anyone else.”

“I hate being sick like this,” he admitted. “Getting colds all the time was bad enough, but when I got tuberculosis I realized that this is my future. I’m going to be in and out of the hospital for the rest of my life. I don’t know if I can live like that.”

“We’re treating your tuberculosis. You’re going to be fine.”

“This time. That won’t always be the case. I keep thinking about when I was in the ICU waiting for the transplant. The chances of recovery after all that time, all those complications, were incredibly low. Even though I was sedated, I remember some things from when I was in the ICU - being tied to the bed, having a tube shoved down my throat, being in incredible pain. I don’t want to go through that again.”

“Do you trust me, Phil?” she asked.

“Of course.”

“Then you know that I won’t let that happen to you,” she said.

He drove in silence for a while before asking, “Do you think this woman actually knows what happened with Skye’s mother? Or this this just a ploy to cheer me up?”

“Both. You’ve always been happiest when you’re helping other people, and she might remember something from back then. Residents are always gossiping about each other.”

“Well I’m glad we’re going. Skye deserves a chance to know her mother.”

*****

The patient interview took a lot longer than Donnie anticipated. The patient was so severely demented that he could barely tell him anything. Every time Donnie asked him a question, he answered, “Son, I have the Alzheimer’s. I don’t remember that.”

"Sir," Donnie said trying to stay patient, "I have to get your history. Otherwise I don't know what to do with you."

"Call my daughter. She can tell you everything." The man held up his wrist. He had a silver ID bracelet engraved with Maria Garza (daughter) followed by a phone number.

As he scribbled down the number, Donnie wondered what life was like for Maria Garza. He tried to find her in the emergency department waiting room, but the ED resident said that she had been there earlier but had to leave to take care of her children.

“She wanted you to call as soon as he got a bed,” the resident said.

Donnie meant to call her right away, but when he got back to the office he started getting paged by the nurses to enter admission orders. He tried doing it himself, but he kept getting error messages. He was relieved when Fitz came back into the office.

“How demented did the patient wind up being?”

“Pretty bad. He couldn’t tell me anything except to call his daughter.”

“Did he have her number at least?” 

“Yeah, it’s around his wrist.”

“Well that’s something. Do you need anything?”

“Actually I’m having trouble putting in admission orders. Can you help me?”

“Sure.” Fitz sat down at the computer and typed a few things. “There’s your problem. You can’t enter orders until you’ve confirmed the allergies. Did you get that from his family?”

Donnie glanced at the clock. He was running out of time before his meeting with Dr. Quinn, and he did not have time to call Maria Garza, then page Fitz a second time to ask for help putting in orders. He was sure he could figure out how to change the information later if he needed to, and he reasoned that if there were anything serious, it probably would have been on his ID bracelet. “Yeah, no allergies.”

Fitz clicked the no allergies button. “Good. Now we’re in business.” As Fitz showed him how to enter in orders, he talked him through the case. The emergency department had gotten a urine sample that tested positive for an infection.

“I know that you don’t normally treat unless the patient is having symptoms like dysuria, which he denies, but increased confusion can be a symptom in patients with dementia. So maybe we should treat it?” Donnie asked.

“Good idea. What do you want to use?”

“Cipro’s standard for UTI.”

“Right.” As soon as they were done Fitz was interrupted by another page. “Got another admission. Why don’t I take this one? You just focus on this guy.”

Once Fitz had left, Seth came up to him. “Hey, we need to head over to Dr. Quinn’s office. Our meeting’s in five minutes.”

“I still need to talk to this patient’s family first.”

“That’s going to take forever. We can’t keep Dr. Quinn waiting.” Seth dropped his voice even though they were the only ones in the office. “He’s doing us a huge favor even by meeting with us. If he likes us, we won’t have to worry about applying for residency.”

“Maybe you could go on ahead and explain it to him. I’ll be there as soon as I can.”

Seth shook his head. “He wants to meet with both of us. My dad told him all about my research, but it’s yours that he’s really interested in. I can’t do this without you. It sounds like this guy isn’t that sick. You can talk to his family later.”

Donnie felt guilty, but Seth was right. This meeting was why they had come to S.H.I.E.L.D. for an away rotation in the first place. “Okay.” Before they could leave the office, his pager went off again. 

“Silence that thing,” Seth said. 

It was a message from Mr. Garza’s nurse that his daughter wanted him to call her. Donnie felt a little guilty not calling back as he clicked the pager into silent mode. Hopefully the meeting would not take that long. Fortunately when they got there, Quinn’s secretary ushered them in immediately.

“Thanks for meeting with us, Dr. Quinn,” Seth said as they took their seats.

“Of course. Your father’s told me a lot about you both. The research that you’re doing at Harvard is quite impressive. Especially your project Donnie.”

“Thank you, sir,” Donnie said.

“This is confidential, but I assume I can trust the two of you with this information.” They both nodded. “I’ll be leaving S.H.I.E.L.D. soon to head up the research division at Centipede. Part of my job is to inject new life into their programs by bringing in brilliant young scientists like you two.”

“Won’t it matter that we haven’t done residency yet?” Donnie asked.

“No. There’s no point in wasting three years in residency, disimpacting old people and dolling out pain meds, if what you want to do is research.”

“And we’d start as independent investigators? Not just research techs,” Seth asked.

“That’s right. You’d have your own lab and a six figure salary.” Quinn watched the grin spread across Seth’s face. Donnie however did not look as pleased, and Quinn frowned. “I don’t offer this kind of deal to just anyone. I heard that you two are special, but I need an answer.”

“Yes. Absolutely Dr. Quinn. We’re in,” Seth said. He looked at Donnie, who looked more unsure.

“Can I have more time?” Donnie stammered.

Quinn looked from Donnie to Seth. “You have twenty-four hours. And remember, this offer is only good for the two of you as a team.”

*****

Coulson and May found Dr. Avery outside one of the medical school lecture halls. 

“Dr. Avery,” Coulson said. “We were hoping you could answer some questions for us about someone you knew in residency.”

“Is this about Skye?”

Coulson and May glanced at each other. “How did you know that?” Coulson asked.

“Her father contacted me when she got into S.H.I.E.L.D. He was worried that she would be digging into her past.”

“She has been. She tried talking to some of her father’s colleagues from residency, but she didn’t get anywhere, so she asked for my help,” Coulson said.

Avery sighed. “I told him that he couldn’t keep this a secret forever. It’s better if it were out in the open.”

“So you remember what happened.”

“Of course I do. Everyone at S.H.I.E.L.D. was talking about it. I was his intern on pediatric surgery when it happened.”

“When what happened?” May asked.

“When Skye came into the hospital.”

“She was sick?”

“She was abandoned outside the ER when she was just a few weeks old. When they checked her out in the ER they found that she had congenital heart disease. She was in the PICU for a long time getting it repaired. Her father was my senior resident at the time, and he was so attached to her. He used to stay late and come in early to talk to her and sing to her. When she was discharged, he and his wife took her in as a foster kid. But Skye was sicker than I think they realized. She had to keep coming back to the hospital for more surgeries. Every time she did, her parents would be screaming at each other in the waiting room. I guess his wife couldn’t handle taking care of a sick baby alone all day while her husband was at the hospital. Eventually she left him, and he adopted her alone.”

Coulson and May exchanged a shocked look. Skye had never mentioned being adopted. “How much of this does Skye know?” Coulson asked.

“Not much,” Avery said. “She knows about the surgeries. I remember that she used to complain a lot about having to get her heart checked out. But her father didn’t want her to know about the adoption or how she was found. He thought it was too much for a child to handle.”

“Did they ever find her parents?”

“Not that I know of. Most people thought they were homeless or drug addicts, but I always thought they were some kind of politicians or diplomats.”

“What made you think that?” Coulson asked.

“She looked too well-cared for when she arrived. She was clean and well-fed, and wrapped up in a nice blanket.” She smiled a little. “When they found her, she was lying in a Skyy vodka box. That’s how she got her name.”

On the drive back to DC both Coulson and May thought about what Avery had told them.

May was the first to break the silence. “You can’t tell her.”

“What right does anyone have to keep this from her? She’s an adult, and she wants to know the truth.”

“The truth is going to devastate her.”

*****

On their way back to the office, Seth said, “What’s the problem, Donnie? This is what we talked about. Doing research with the money and resources to make the big discoveries.”

“What about residency?”

“Why spend another three years working our assess off and being poor if we don’t have to? This will jumpstart our careers.”

“Yeah -”

They were interrupted by the commotion outside of Mr. Garza’s room. The door was open, and there was a crowd of people and equipment spilling into the hallway. Callie was in the hall right outside the room with a phone pressed to her ear.

Seth grabbed her arm. “What’s going on?”

“Where have you been, Donnie?” she asked. “Your new patient coded.”

All the blood drained from Donnie’s face. “What?” He ran into the room.

The interns were all crowded around the bed. Simmons was frantically doing chest compressions while Skye and Ward put in an emergency central line. Fitz was on the computer frantically looking up information in his chart. Dr. Foster from the ICU was at the head of the bed intubating him.

Hill stood at the foot of the bed surveying the scene in front of them. Hill asked Callie, “Any word from the family?”

“Still trying to reach them. I’ve called every number in the chart, but they’re not picking up,” Callie shouted to be heard over the noise.

Hill nodded and stared at the clock. “Keep trying,” she told Callie. To Simmons she said, “Hold compressions. Check for a pulse. Get ready to push another amp of epi, and Fitz, get ready to take over chest compressions.”

Simmons pressed her fingers to the patient’s neck. A look of relief washed over her face. “I’ve got one. It’s faint, but it’s there.”

“Hold the epi then. Get some vitals and get him ready to roll up to the ICU,” Hill said. Then she turned to Fitz, “Fitz, got anything from his chart?”

“No. Labs, chest x-ray, everything looked fine except for the urinary tract infection.”

“Were you able to get more of a history from his family?”

“No, Donnie talked to them.” Fitz noticed Donnie standing next to Seth in the doorway. “What did the family say, Donnie?”

“Nothing helpful. They didn’t know much,” he lied. “What happened?”

“The nurse found him in cardiac arrest,” Fitz said.

Hill looked angry. “We’ve been paging you. Where were you?”

Donnie realized that his pager was still on silent. There were several increasingly urgent missed messages from Fitz, as well as another message asking him to call the patient’s daughter. “Oh. I guess my pager was turned off.”

Ward said, “You can never turn off your pager. We needed you here. Your patient almost died.”

Just then Callie came into room followed by a woman. “Mr. Garza’s daughter just arrived.”

When Maria Garza saw her father lying on the bed she looked furious. “What the hell happened?”

Ward tried to calm her down. “Your father went into cardiac arrest, but we’ve resuscitated him. He’ll be going to the ICU -”

Ms. Garza cut him off, “I can see that. But who gave you permission. He’s DNR.”

“What? I’m sorry ma’am, but we didn’t know.”

“You would have known if someone had bothered to call me like I asked.”

Fitz looked at Donnie. “But Donnie said that he talked to you -”

“I’ve been asking for the doctor to call me all afternoon. The only call I got was a message on my cellphone a few minutes ago saying he was in critical condition. I live nearby, so I came right in.”

Fitz looked stunned, and Ward looked furious. Hill though stayed calm and asked Ms. Garza, “Can you tell us what’s been going on with your father at home? Anything at all that might explain this?”

“No, he was fine. I thought he had another urinary tract infection, but before I could take him to the doctor he wandered out in the middle of the night.” Her face clouded. “You didn’t give him cipro from the infection, did you?”

“Why not cipro?” Fitz asked warily.

“He’s allergic to it.” Ms. Garza and the doctors all looked at his IV pole, which had an empty bag of cipro hanging on it. Ms. Garza was shaking with anger. “I’m calling my lawyer. What kind of a hospital is this?”

Before things could escalate further Hill said calmly, “Ms. Garza, I apologize for this situation. Why don’t we talk someplace private about all of this with our ICU fellow?” She and Foster ushered Garza out to the conference room.

As soon as they left Ward demanded, “What happened? The truth this time.”

“Hey, Donnie’s a good guy. I’m sure there’s a reasonable explanation,” Fitz said. “Right Donnie?”

Donnie stared at his feet and slowly shook his head.

*****

When Coulson dropped May off at her house, he spotted Skye getting out of her car just a few spots away. She waved and walked over.

“Hey,” she said cheerfully. “I was just meeting Simmons for dinner. What are you up to?”

“Just dropping off Melinda,” Coulson said. He had trouble meeting Skye’s friendly smile. 

She seemed to notice his tense expression because she said, “Is everything okay?”

“Fine.”

“Are you sure? Are you feeling sick again? Have you been having side effects from your antibiotics?” 

“It’s nothing like that,” he assured her. She looked so worried about him. He could not bear to keep this secret from her. “Why don’t you get in?” Once she was seated inside Lola, he continued, “The truth is, Melinda and I went to Baltimore to talk to someone who was at S.H.I.E.L.D. when your father was a resident.”

“You found out about my mother.” Skye’s face lit up.

“It’s not good,” he warned her.

Her face fell, but she said, “It can’t be worse than I imagined.”

“It is.” He waited to see if she would back down, but she looked at him expectantly. “The woman who you think was your mother, your father’s wife, she wasn’t actually your mother. You were their foster child. You were found outside of the ER when you were a baby. Because of your heart defect, you spent several months in the PICU. Your father was on a pediatric surgery rotation at the time, and he arranged to take you in after you were discharged. His wife left before he formally adopted you.” Skye stared at her feet. Her hair fell in front of her face, and he could not read her expression. He worried that May was right, that this information would devastate her. “Skye, are you okay?”

She nodded and looked up. There were tears in her eyes, but she was smiling a little. “My whole life I felt like no one wanted me. My mom was gone, and my dad worked all the time. I was always alone or with babysitters. When I did see my dad, he was usually disappointed in me about something - my grades, my attitude, my friends. I thought he was ashamed to be stuck with me. But he wasn’t. He chose me. Even before I was his kid, when I was just one of his patients, he wanted to take care of me and be my dad.”

Coulson was surprised at her interpretation of what he had told her.

“We haven’t really talked since I got into S.H.I.E.L.D. He didn’t want me to come here. I thought it was because he was ashamed that I didn’t get into a surgery program, but I guess it was really because he wanted to protect me. I should give him a call.” She leaned over the gear shift and awkwardly hugged him. “Thank you so much for finding all this out for me.”

“You’re welcome.”

“Are you going to be back at work soon?”

“Probably next week. How are things at the hospital? The visiting medical students were supposed to start today. How are they settling in?”

Skye grimaced. “Actually there were a few problems with that.”

*****

On his first day back, Coulson stopped by Hill’s office as soon as he arrived.

“I heard what happened with the medical students. I’m sorry. I thought it would be a good way to raise the profile of the program.”

Hill looked tired. “That didn’t work out so well.”

“How’s the patient and his family?”

“He’s okay. They were able to extubate him the next day. His daughter hired a lawyer, and the hospital lawyers are going to settle.”

“How angry was Fury when he heard?”

“Pretty angry. Donnie Gill admitted that he and Seth Dormer were at a meeting with Ian Quinn about a biotech job at Centipede when the patient coded. When Fury heard that he sent Donnie and Seth back to Harvard, and he revoked sub-intern privileges from all the med students.”

Coulson shook his head. With something like this on their records there was no way a residency program would accept either Seth or Donnie. It was hard to feel sympathy for them after everything their lies had caused for the patient and the hospital, but he still wondered what would happen to them now.

**Notes for the Chapter:**

> We’re taking a little hiatus from Doctors of S.H.I.E.L.D. for now. We still plan to write one chapter for each episode, but given that the next few episodes are going to be very connected, we want to wait to see how these big storylines unfold before we dive into adapting Episode 1x13, T.R.A.C.K.S.


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